Peer-reviewed article
Parenthood and gender differences in French GPs' labour supply responses to declining physician density: panel fixed-effects evidence.
Paraponaris A, Silhol J, Ventelou B ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines how French general practitioners adjust their working hours and income in response to local shortages of physicians, and whether family circumstances explain differences between male and female doctors. The research uses tax and demographic data from 2,898 self-employed GPs between 2010 and 2017. It finds that when physician density declines, GPs modestly increase their income, but this response differs significantly between men and women, particularly when they have dependent children.
Key points
- A 10% decrease in GP density is associated with a 1.7-1.8% increase in private practice income
- Male GPs increase income by 2.2% in response to declining physician density, while female GPs show no significant response overall
- Among physicians without dependent children, both men and women show similar labour supply responses (men +2.4%, women +1.9%)
- Gender differences in labour supply adjustment primarily reflect unequal family responsibilities during child-rearing years rather than gender itself
- Self-employed GPs only partially adjust their labour supply despite local physician shortages
Limitations
This study focuses exclusively on adult physicians' labour market behaviour and does not examine impacts on child health outcomes, access to care for children, or any other aspects of child well-being. It cannot inform us about how physician shortages or their responses affect children's health, development, or care.
Abstract
Background Declining physician density threatens access to primary care. Although physicians may adjust their labour supply in response to local shortages, little is known about the extent of these adjustments and the role of family circumstances in shaping them. Objective To examine how French self-employed GPs adjust their labour supply to declining physician density and whether family circumstances explain observed gender differences. Methods We analyse a representative 4.4% panel of 2898 self-employed French GPs observed from 2010 to 2017 (INSEE Permanent Demographic Sample matched with tax and territorial data). Labour supply is proxied by private practice income. Physician fixed-effects models relate income to local physician density, controlling for individual, household and territorial characteristics. Heterogeneity analyses consider gender and family composition. Results A 10% decrease in GP density is associated with a 1.7-1.8% increase in private practice income (p < 0.01), indicating partial labour supply adjustment. Male GPs increase income by about 2.2% (p < 0.01), whereas no significant response is observed among female GPs overall. Among physicians without dependent children, however, responses are similar for men (+2.4%) and women (+1.9%) (both p < 0.01), suggesting that gender differences primarily reflect unequal family responsibilities during the child-rearing years rather than gender itself. Conclusions Self-employed GPs partially adjust their labour supply to declining physician density, but these responses vary with family circumstances. Policies improving access to primary care should therefore complement workforce planning with measures that facilitate the reconciliation of professional and family responsibilities.