Tamri Matiashvili (Stanford): Talent, Trust, and Health: The Effects of the First Female Physicians
Abstract: How did the entry of women into high-skill occupations shape the productivity of those professions? This paper examines the large-scale entry of female physicians into the medical profession following the opening of the world’s first full-length medical school for women in the Russian Empire in 1872. I digitize novel annual data on physician employment and vital statistics in more than 330 districts from 1876 to 1910, as well as data on direct healthcare provision metrics from 1876 to 1888. Using a staggered difference-in-differences design based on quasi-random timing of replacement hires of general practitioners in the rural public healthcare system of the Russian Empire, I find that the first female physician entry led to large and persistent declines in infant mortality (7%) and in young adult mortality of both sexes (7-13%), resulting in faster population growth (11%) and increased life expectancy (4-5%). The first female physicians improved hospital care and drew more female patients to formal medical care, as suggested by their displacement of midwives. I construct physician-level estimates of medical value added and develop a conceptual framework to disentangle productivity differences from demand-side concordance-preference mechanisms. The evidence indicates that the observed mortality declines reflect both the greater effectiveness of the earliest female physicians relative to incumbent male doctors and increased care-seeking among women. I then test the long-run implications of this framework using modern data.
Economics
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