Harvard economist argues that Match is not anticompetitive
Lawyers for plaintiffs in Match antitrust lawsuit cite other studies suggesting that matching systems do depress wages.
By Myrle Croasdale, AMNews staff. Oct. 13, 2003.
The National Resident Matching Program is not the culprit behind residents' relatively low wages, says Alvin Roth, PhD, a Harvard University economist and author of the Match's mathematical formula that links medical students with residencies.
Dr. Roth argued his perspective, which is contrary to claims made in an ongoing lawsuit against the Match, in an economic analysis in the Sept. 3 issue of the Journal of the American Medical Association. "The scientific hypothesis seems to say matches per se lower wages, and [the economic analysis] seems to say strongly that that hypothesis is false," Dr. Roth said.
In May 2002, three residents filed a lawsuit alleging that the Match artificially depresses resident wages and restrains competition. The plaintiffs are seeking class-action status for all residents in the country.
Dr. Roth and his co-author looked at fellowship salaries to test the premise that abandoning the Match would cause resident salaries to rise. Internal medicine subspecialty programs within the same hospitals were compared. Some of the subspecialty programs participated in the Medical Specialties Matching Program, while others did not.
"Unlike residency training, fellowships are an optional part of a career path," Dr. Roth and his co-author stated. "Thus, potential fellows have market alternatives; fellowship programs must compete not only with other programs, but with less-specialized medical positions, because fellows could practice medicine without pursuing a fellowship."
They found that wages were not significantly different for programs that used the Match compared with those that did not. Fellows had the choice of going into higher-paying practices, but fellowship wages did not rise to make the positions more attractive. This suggests that the matching process is unrelated to the relatively low wages involved, Dr. Roth said.
Attorneys for the three physicians who brought the suit countered that other economic models show that matching systems do depress wages.
Sherman Marek, one of the attorneys representing the plaintiffs, said, "Our economic experts simply disagree with [Dr.] Roth. Their own comprehensive analyses conclude that the [Match] is an important element of a greater anticompetitive scheme that depresses and standardizes resident wages. ... Our experts' conclusions are consistent with economic theory and antitrust law generally, which hold that 'horizontal market division' or 'horizontal customer allocation' schemes [like a match] unlawfully impact pricing."
Dr. Roth responded that the theoretical papers he was aware of examined models that looked at matching but were not necessarily applicable to medicine.
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