Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes

American Economic Journal: Applied Economics (Forthcoming)

Abstract

This paper studies whether more skilled physicians improve birth outcomes. We exploit a natural experiment in Colombia, where newly graduated physicians were randomly assigned to Local Health Centers (LHCs), to estimate the causal effect of being treated by a more skilled physician—measured using medical graduation exam scores—on newborn health. We find that mothers treated at LHCs assigned physicians with exam scores one standard deviation higher were 9.14 percent less likely to give birth to an unhealthy newborn. Suggestive evidence indicates that more skilled physicians achieve these results by better targeting prenatal care toward high-risk mothers without reducing care for others.