Research
Research
Work in Progress
The United States faces a projected shortage of up to 86,000 physicians by 2036, with rural and underserved communities bearing a disproportionate burden. Despite medical school expansion being a prominent policy response to these shortages, little research examines how new schools affect local physician supply. I evaluate the effect of medical school openings on local physician supply using a stacked difference-in-differences framework with a matched control group. To measure physician supply, I use the National Plan and Provider Enumeration System (NPPES), which allows me to track not only the stock of physicians in an area but also the underlying provider flows driving any changes. I find that counties opening a medical school experience an increase of 0.21 MDs and 0.06 DOs per 1,000 population over the following decade. These estimates correspond to an average increase of roughly 60 additional MDs and 17 additional DOs, representing an 8.4 and 38.6 percent increase in the number of MDs and DOs, respectively. Notably, increases in physician density begin shortly after a school's establishment, prior to any graduates entering practice, suggesting that medical schools function not only as training pipelines but also as amenities that attract established physicians to the area.
State Loan Repayment Programs (SLRPs) are a prominent policy tool for addressing healthcare provider shortages in underserved areas, yet little is known about how participation shapes providers' subsequent location decisions. I characterize applicants to the Colorado Health Service Corps (CHSC) and document their location decisions using administrative data from Colorado's Primary Care Office matched to longitudinal practice location data from the National Plan and Provider Enumeration System. A key contribution of this paper is the ability to identify both awarded and unawarded applicants, allowing me to compare the location patterns of providers who received a loan repayment offer against those who were willing to serve in a shortage area but were not funded. I find that offered providers are less likely to move during their obligation period relative to the not offered, consistent with the program's service requirement. However, this pattern reverses in the first two years following the obligation period, with offered providers exhibiting notably higher mobility. These findings suggest that the CHSC is able to recruit individuals into underserved areas in Colorado; however, its impact on long-term retention is less clear.Â
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