Income and the Location of Practice

A WISE CHOICE of a profession may improve an individual's chance of earning a good livelihood; it cannot guarantee him success. The attempts of numerous individuals to choose wisely limit the opportunities for profiting by a wise choice and tend to equalize, not incomes, but the "whole of the advantages and disadvantages" of different professions. In addition, as we have seen, the incomes of men who practise the same profession differ widely. Some attain a professional status that enables them to sell at attractive prices all the services they care to render; others find it difficult to sell their services even at low prices.

The factors that determine a professional man's income are numerous and varied. Some, like profession, give rise to differences that the forces of competition continually tend to obliterate. Others, either by their very nature or for institutional reasons, give rise to differences competition alone cannot touch. Few are susceptible of quantitative or objective evaluation. How can we measure 'personality', the influence of family and personal connections, and the like? Finally, there are the many factors of which we are ignorant; these we usually combine with the ever-present element of 'pure luck', under the convenient heading of 'chance'.

Changes in the relative economic advantages of different professions are reflected primarily in the number of young people who each year start to train for them. Changes in the relative advantages of different localities, on the other hand, are reflected in the geographic distribution of both young people just beginning practice or training and persons already in active practice. However, the difference between professional and geographical mobility is probably not great. The uncertainties attached to beginning anew elsewhere, the capital needed to cover living expenses during the period of adjustment, and the direct costs of moving combine with inertia and habit to keep professional men from moving to new and possibly more advantageous locations. These obstacles are especially serious for men in independent practice because of the capital value represented by an established practice, and the inevitably low level of earnings during the initial period in a new location. The individuals who have fared poorly in their present location have the greatest incentive to move; but they are least likely to have the necessary capital. Those who have done well will probably have less difficulty in procuring capital, but they have less to gain and more to lose by moving. Consequently, new entrants probably play almost as large a role in adjustments among localities as in adjustments among professions.