Patient preferences and physician availability based on physician nativity and international medical school attendance

Abstract

Roughly a quarter of physicians in the United States are either international medical graduates (IMGs) or foreign-born physicians (FBPs). We propose a theoretical model where patient preferences that disfavor IMGs/FBPs may result in these physicians offering better access to their services compared with non-IMGs/FBPs in equilibrium. We use data from two field experiments to test the predictions from the model: one concerning patient preferences and the other concerning physician availability. In the patient preferences field experiment, we find that patients strongly prefer physicians educated in the United States to IMGs by more than 2-to-1. In the physician availability field experiment, we find that US-born physicians generally have lower levels of availability including offering fewer appointments and longer wait times. These results may indicate a substantial underutilization of FBPs relative to US-born physicians and suggest that greater acceptance of IMGs/FBPs will improve access to healthcare in a system that is constrained by supply shortages.