Dartmouth-Led Study Finds That Married Physicians Who Are “Power Couples” Are Less Likely to Work in Rural Areas


March 1, 2016

Married physicians with highly educated spouses (“power couples”) are less likely to practice in rural underserved areas according to a new study published in the Journal of the American Medical Association. (NOTE: A pdf of the study is available upon request).

The study examines 1 percent of all employed physicians ages 25 to 70 years working in the U.S. every 10 years from 1960 to 2000 (n = 19,668) and from every year from 2005 to 2011 (n=55,381) based on data from the Decennial Census and the American Community Survey, respectively.

The proportion of married physicians who are power couples increased from 8.8 percent in 1960 to 54.1 percent in 2010. Compared with other married physicians, those with highly educated spouses were significantly less likely to work in a rural Health Professional Shortage Area (HPSA)— 4.2 percent vs. 7.2 percent. Single physicians were also less likely to work in a rural HPSA or 4.1 percent for single physicians vs. 7.2 percent for married physicians without highly educated spouses, as were physicians who were young, women, black, or Hispanic.

“Our evidence suggests that increasingly physicians have highly educated spouses with independent careers, and this constrains their ability to locate in rural under-served areas,” says the lead author of the study, Douglas O. Staiger, the John French Professor in Economics at Dartmouth.

Policies, such as provisions that enable physicians to practice in rural underserved areas but not relocate such as via telemedicine, are necessary to help counter the shortage of physicians serving in rural areas.

Available for comment on the study is Douglas O. Staiger, the John French Professor in Economics at Dartmouth, at: douglas.o.staiger@dartmouth.edu.

Samuel M. Marshall, a former undergraduate student at Dartmouth, who is now a graduate student at Arizona State University; David C. Goodman at the Geisel School of Medicine at Dartmouth; David I. Auerbach at Vanderbilt University; and Peter I. Buerhaus at Montana State University; also served as co-authors of the study.


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