Shirley Cai

Shirley Cai

they/them, she/her

PhD Candidate

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Medical School Environments and Physician Treatment Styles

Shirley Cai and Ian McCarthy

We examine the role of medical school environments in shaping physicians’ later treatment decisions, focusing on a specific subset of cardiology in which physician discretion is particularly salient and separate from patient need.

Formation of Physician Referral Networks: Drivers and Potential Consequences

Ian McCarthy, Shirley Cai, Pablo Estrada, and Jillian Wilkins

Focusing on PCPs who enter or relocate to a new market, we study the determinants of initial PCP–specialist networks using the universe of 2010–2018 Medicare fee-for-service claims across three distinct specialty areas: orthopedic surgery, cardiology, and dermatology. A network-formation model with two-sided fixed effects shows that sharing a common practice is the dominant factor in forming initial referral links across all three specialties, followed by geographic proximity and relatively minor effects from homophily across various demographic characteristics.

Nurse Scope of Practice Expansions and Physician Location

Shirley Cai

This study seeks to disentangle these two pathways by examining PCP location response to SOP expansion using a difference-in-differences design, leveraging staggered state adoption of SOP laws. I find that neither aggregate PCP location nor new PCP location responds to expanded SOP. However, PCPs and new PCPs increase in counties with high pre-period APRN presence, suggesting that APRNs and PCPs are complements in these markets. Overall, I find little evidence that SOP expansion induces physicians to leave markets due to ARPN competition. Instead, expanded SOP appears to allow APRNs to provide primary care without crowding out incumbent PCPs.

Nursing Home Staffing and Quality: Evidence from Japan

Karen Eggleston, Toshiaki Iizuka, Yong Suk Lee, Shirley Cai, Rosina Lin, and Carter Nakamoto

Analyzing survey data from more than 1000 Japanese nursing homes, we find that an increase in more full-time equivalent direct-care staff per resident is associated with fewer pressure ulcers.

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