Physician Labor Mobility post Dobbs

• In Event: Physician Pathways under Policy Shift: Capital, Care, and Career Moves

Abstract

The Dobbs decision, issued by the U.S. Supreme Court in June 2022, granted states the authority to restrict abortion access. As of 2024, twenty states have either banned abortion or imposed restrictions earlier in pregnancy than the standard established by Roe v. Wade. This study aims to investigate how this legal shift influences physicians’ decisions to relocate, given anecdotal reporting around uncertainties in professional environments, job opportunities, and ideological alignment. Specifically, we hypothesize that physicians in states with abortion bans are more likely to move to or opt for positions in states without such restrictions due to concerns about uncertain environments, legal consequences for providing certain types of pregnancy-related medical care, as well as preferences to practice the full range of medically relevant care to their patients. To address this research question, we analyze monthly data from the National Plan and Provider Enumeration System (NPPES), provided by the Center for Medicare and Medicaid Services (CMS), spanning from 2017 to 2024. This dataset includes information on U.S. physicians’ names, genders, addresses, and specialties. Using a difference-in-differences approach, we estimate the impact of the Dobbs decision on physicians’ mobility by analyzing monthly, state-level move-out percentages. As new physicians often move following residency, we also evaluate their initial location decisions following the Dobbs decision. Finally, we explore heterogeneous effects by physician gender and specialty to provide a more nuanced understanding of these mobility patterns. We hypothesize that physicians specializing in pregnancy-related care and female physicians may be more likely to relocate. This study contributes to the ongoing discussion on how state abortion policies are influencing physicians’ relocation decisions, reshaping the geographical distribution of healthcare services, and redefining the broader landscape of medical practice in the United States. Additionally, it responds to the critical issue of the physician shortage in the United States by examining how legal and ideological factors may exacerbate or mitigate this challenge through their impact on physician mobility and distribution.

Authors

• Seth Freedman, Indiana University
  Non-Presenting Co-Author

• Kosali Simon, Indiana University
  Non-Presenting Co-Author

• Nicole Y Siegal, Indiana University
  Non-Presenting Co-Author

• Coady Wing, Indiana University
  Non-Presenting Co-Author

• Jiaen Wu, Indiana University
  Presenting Author