Elaine Guo

Working Paper

"Physician Gender Pay Gap: Practice Style and Selection", 2023, with Jasmin Kantarevic.


This paper explores the roles of selection and practice style in driving the well documented physician gender pay gap. We leverage rich administrative health care data from Ontario, Canada’s most populous province, along with a quasi-experiment that randomly assigns physicians in emergency departments based on exogenous physician availabilities. We find that both selection and practice style are important channels explaining the physician gender pay gap. Selection of female physicians to lower-paying cases, in particular to lower-paying shifts, leads to a 5% gap in male and female physicians’ per-visit pay. Female physicians also spend around 10% more time on each case than male physicians, which negatively affects the volume of cases they can process. Additional evidence suggests that female physicians tend to adopt a more resource-intensive practice style when clinically appropriate, leading to better patient outcomes.

"Social Media and Teenage Mental Health: Quasi-Experimental Evidence", 2022.


Teenage mental health has been a source of growing concern over the past decade, with recent whistleblower testimony pointing to the mental health risks of spending time on social media platforms, especially for girls. This paper investigates the extent to which social media are harmful for teenagers, leveraging rich administrative data from the Canadian province of British Columbia and quasi-experimental variation related to the introduction of wireless internet there. I show neighbourhoods covered by high- speed wireless internet have significantly higher social media use, based on Google search volume data. In the main analysis, I link spatial data on broadband coverage to 20 years of student records that provide detailed information about individual student health. Using this novel data linkage, I estimate a triple-difference model comparing teen girls to teen boys in terms of school-reported mental health diagnoses, before and after visual social media emerged, and across neighbourhoods with and without access to high-speed wireless internet. Estimates indicate high-speed wireless internet significantly increased teen girls’ severe mental health diagnoses – by 90% – relative to teen boys over the period when visual social media became dominant in teenage internet use. I find similar effects across all subgroups. When applying the same strategy, I find null impacts for placebo health conditions – ones through which there is no clear channel for social media to operate. The evidence points to adverse effects of visual social media, in light of large gender gaps in visual social media use and documented risks. In turn, the analysis calls attention to policy interventions that could mitigate the harm to young people due to their online activities.

"Team-Based Care and Mental Health Service Provision: Evidence from Ontario", 2022, with Claire de Oliveira. Working Paper


This paper assesses the efficacy of team-based care, an increasingly popular mode of healthcare delivery. We study overall health outcomes as well as mental health, an area historically under-served by physicians. We use an event study approach that leverages rich administrative healthcare data from Canada’s most populous province, Ontario, and quasi-experimental variation associated with the introduction of the province-wide Family Health Team (FHT) policy. We find FHTs significantly improved overall primary care quality, reducing emergency room use by around 7% after four years. Concerning mental health care, we find evidence consistent with an adjustment in care provision: while early-wave FHTs substituted social workers for physicians, yielding no change in quality, later-wave FHTs saw significant quality improvements, with physicians and social workers collaborating. These findings indicate team-based care is not a fixed treatment: optimal outcomes are achieved when the deployment of interdisciplinary providers takes into account the degree of treatment substitutability.


"Evaluating the Applicability of Lexicon-Based Sentiment Analysis on Family Medicine Residency Field Notes", 2023, with Kevin (Jia Qi) Lu, Christopher Meaney, Fok-Han Leung, JMIR Medical Education, 9: e41953. Published Version

"Inequity in Insurance Coverage for Prescription Drugs in New Brunswick, Canada", 2022, with Busola Ayodele, Arthur Sweetman and Emmanuel Guindon, Canadian Journal of Public Health, 113: 504-18. Published Version

"Socioeconomic Differences in Prescription Drug Supplemental Coverage in Canada: A Repeated Cross-sectional Study", 2020, with Arthur Sweetman and Emmanuel Guindon, Health Policy, 124: 252-60. Published Version