Research
Working Papers
▾ Abstract
Does restricting the entry of physicians affect our physician supply and delivery of care? This paper studies how easing licensing requirements for non-U.S.-citizen physicians affects the physician supply, hospital capacity and utilization, and population mortality. From 1960 through the 1970s, more than thirty states removed citizenship requirements for medical licensure. Using novel licensure and physician data that I digitized from historical records, I show that easing a licensing requirement changes physician supply through expanding entry into licensing. It also increases the share of licensed physicians among the total physician stock, all with no detectable crowd-out of the U.S.-trained physicians. Considering quality, I find little evidence of higher mortality rates or negative selection into licensing in physician quality, measured by the average license exam pass rate of each licensed cohort. Hospitals respond by expanding staffed beds by about 4 percent. Bed expansion is concentrated in areas with growing demand for health care, i.e., among counties with above-median Medicaid exposure. Heterogeneity analysis across calendar years shows both license flow and bed expansion emerged in years after the federal government expanded access to permanent residency for J-1 visa holders in 1970, consistent with federal visa policy being a complementary barrier for foreign-trained physicians. Together, these findings suggest that licensing barriers unrelated to clinical qualifications can restrict entry into practice and limit hospital capacity, particularly where demand for care is growing.
▾ Abstract
Females' increased participation in the workforce in the past century was the most significant change in the US labor market (Goldin, 2006). An often cited, but understudied, reason for females' increased LFP was the elimination of the marriage bar, a policy prohibiting married women from working. We gathered new data from 1900–1940 to document the prevalence of the marriage bar in teaching across US cities. Using the 1880–1940 Census and a difference-in-differences design, we show that marriage bars decreased the share of married female teachers by 2.3 percentage points (15%). This decrease was offset by an increase in single female teachers. We also find suggestive evidence that marriage bars increased retention among single teachers and possibly delayed or deterred marriage, particularly for older women and those exposed to the policy longer. These findings highlight the role of discriminatory employment policies in affecting work forces and workers' family decisions.
Publications
▾ Abstract
Using data on the NBER working paper series, we show that the dissemination of economics research suffers from a congestion problem: An increase in the number of weekly released working papers on average reduces downloads, abstract views, and media attention for each paper. Subsequent publishing and citation outcomes are harmed as well. Papers written by prominent authors are not immune to this congestion effect. Finally, suggestive evidence on viewership and downloads implies that working papers substitute for the dissemination function of publication. Our results highlight how readers face time and cognitive constraints, with increased congestion in working papers leading to real impacts on how research is consumed.