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At least 109 records · Page 6Linked to original sources
PubMed2003

Recruitment of rural health care providers: a regional recruiter strategy.

CONTEXT: Access to care in rural areas is a major problem. Despite more than 20% of the US population residing in these areas, only 9% of physicians practice there. Extensive research has documented multiple issues that affect where physicians decide to locate and maintain practices. Creative strategies have been used to influence these recruitment and retention decisions. An emerging strategy, borne out of the Robert Wood Johnson Foundation's Southern Rural Access Program (SRAP), effectively uses a targeted regional approach to assist rural communities and health care facilities in assessing health care needs and recruiting primary care providers. PURPOSE: This article examines the issues surrounding recruitment and retention of primary care providers to rural areas and describes the experiences of the regional recruitment strategy in several states and in particular in the Mississippi Delta region of Arkansas. METHODS: A case study approach is used to examine the targeted regional recruiter strategy in the Mississippi Delta region of Arkansas. FINDINGS: The regional recruiter strategy, which combines traditional recruitment efforts with community development activities, has been successful in recruiting health care providers to rural communities. The cost-effective strategy can be easily replicated in other rural states. CONCLUSIONS: Community factors affect provider decisions on practice locations. Addressing community factors in recruitment efforts through community development activities may increase their success.

Arkansas↗
PubMed1997

Factors affecting specialty and location of practice of government-sponsored physicians in Taiwan.

Geographic and specialty maldistribution have created problems of physician supply in Taiwan. Previous small-scale government-sponsored physician (GSP) programs in Taiwan have had only limited effects. To solve this problem, the National Yang-Ming Medical College was established in 1975; it supplied its first government-sponsored physician graduates in 1982. Obligatory service in different specialties and geographic areas were assigned to graduates according to their personal preference and school performance. In this study, we evaluated the factors affecting the choice of specialty and location for these GSPs during the 6-year obligatory service period. Data on Department of Health-regulated GSPs who finished obligatory service prior to 1991 were obtained from the GSP files, medical student files, and the National Medical Manpower Information System for the years 1982 to 1985. Logistic regression was used to assess the effect of year of entry, age, gender, rank in class, and hometown of the GSPs on specialty choice upon entry into the obligatory service period. Both logistic regression and generalized estimating equations were used to analyze the effects of these parameters and location experiences during obligatory service on location selection after the obligatory service period. We found that rural experience during obligatory service was strongly associated with the choice of rural practice after the completion of the obligatory service. Male gender, a later year of entry to the program, and having a rural hometown were only moderately associated with the choice of rural practice. A more comprehensive evaluation and review of the effect of the GSP program on overall specialty and location distribution of physicians is needed to provide guidelines for improvement of current GSP program policies.

Adult↗
PubMed1989

Practice location factors influencing South Dakota School of Medicine graduates (1977-85).

Physician numbers and placement continue to be major health delivery concerns in the rural state of South Dakota. This study of four-year graduates (1977-1985) of the South Dakota School of Medicine looks at current factors affecting physician placement and compares placement and location selection factors to a previous study of graduates of the medical school when it was a two-year program (1969-1973). Factors influencing physicians locating in South Dakota were: closeness to their home town and or spouses' home town, residency training in small towns, payment of educational loans, medical school clerkships, time of decision, etc. Factors influencing physicians locating in rural communities (less than 5,000) were: growing up in small communities, residency training in small communities, early location decisions, payment of loans, and high medical need.

Career Choice↗
PubMed1983

Location decisions of National Health Service Corps physicians.

Results of a survey of 100 National Health Service Corps (NHSC) physicians in 10 east coast states (94 per cent response rate) indicate that 56 have plans to locate in a rural area after their service obligation is complete and 15 have not yet decided. Those who decide for a rural practice value personal and community factors to a higher degree than professional factors and are more likely to have a primary care practice.

Career Choice↗
PubMedDate not supplied

Can a 3-day preceptorship change first-year medical students' opinions about living and working in small towns?

BACKGROUND: Research of medical school initiatives that attempt to orient medical students toward rural medicine may facilitate development of initiatives to alleviate physician maldistribution. This study investigated the effect of a 3-day family medicine preceptorship in a small town on first-year medical students' opinions about a) living and working in small towns and b) plans to live in and practice medicine in small towns. Student feedback about the preceptorship was also examined. METHODS: Questionnaires were administered to 137 first-year medical students using a separate sample pretest-posttest design. RESULTS: Student feedback indicated that the preceptorship was a valuable learning experience, but the preceptorship did not appear to influence students' opinions about or interest in living in and working in small towns or rural areas. CONCLUSION: Brief exposure to rural medicine early in the curriculum appears to have little effect on variables that might precede practice location decisions.

Adult↗
PubMedDate not supplied

Where's the best place to live and raise kids, and incidentally practice dentistry?

Factors involved in the selection of the "best place" to live and raise a family could be related to comparable criteria used in the selection of locations for a dental practitioner interest in providing care for children. A series of state and metropolitan area rankings, developed with voluntary and government agency reports, were reviewed to increase an understanding of the factors that may attract to a particular location (1) families with children and (2) pediatric dental practitioners.

Adolescent↗
PubMed2006

Few Medicaid and uninsured patients are accessing dermatologists.

Uninsured patients and those receiving Medicaid make up a smaller fraction of dermatology practices (5%) than would be predicted by their prevalence in the population (27%). We illustrate the ways in which insurance acceptance patterns and practice composition vary by the age, gender, practice type, and geographic location of the dermatologist.

Adult↗
PubMed2006

Characteristics of osteopathic physicians choosing to practice rural primary care.

As increasing numbers of women and osteopathic physicians enter medical practice, it is important to identify their choices in medical specialty and practice location and the implications these choices have for the future of healthcare in the United States. In 2003, data from the Texas Medical Board and the Office of the [Texas] State Demographer were aggregated to compare the rates at which physicians differed in their choices to practice primary care specialties in a rural location. In addition, the impact of sex and type of medical degree on these choices was examined. Analyses revealed that male osteopathic physicians were 2.3 times more likely than all other physician groups to practice rural primary care. Analyses also revealed that female osteopathic physicians were more likely than other physicians to choose primary care as a specialty and were 2.5 times more likely than female allopathic physicians to practice primary care in a rural location. Policies intended to produce primary care or rural primary care physicians should take into account the effects of gender and osteopathic training.

Choice Behavior↗
PubMed1995

The paediatric oncology community nurse specialist: the influence of employment location and funders on models of practice.

A specialist nursing service has evolved in recent years, to care for children with cancer or leukaemia and their families, and co-ordinate care in the community. These paediatric oncology community nurse specialists (POCNS) are mostly based at regional children's cancer treatment centres, although some are based within paediatric units of district general hospitals. In addition to the National Health Service (NHS), a major source of funding has been provided from a range of charities. This paper examines the impact that the employment location (regional or district) and funding sources have on the process, practice and structure of nursing within the speciality. All 43 POCNSs were interviewed from 28 different hospitals across the United Kingdom and Eire. Thirty-one were based at regional treatment centres, whilst 12 were from district general hospitals. Funding was provided by: the NHS (9); Cancer and Leukaemia in Childhood (CLIC) (10); Cancer Relief Macmillan Fund (5); and other charities (19). Major differences were found according to the location of POCNSs, i.e. the regional model and the district model, and according to funders, i.e. the Macmillan model, the CLIC model and the 'other funders' model. This research suggests that both funding source and location of POCNSs have implications for nursing practice.

Community Health Nursing↗
PubMed2006

Practice locations of graduates of family physician residency and nurse practitioner programs: considerations within the context of institutional culture and curricular innovation through Titles VII and VIII.

BACKGROUND: Studies have described the aggregate results of federal funding for health professions education at the national level, but analysis of the long-term impact of institutional participation in these programs has been limited. PURPOSE: To describe and assess federally supported curricular innovations at East Tennessee State University designed to promote family medicine and nurse practitioner graduate interest in rural and underserved populations. METHODS: Descriptive analysis of a survey to determine practice locations of nurse practitioner graduates (1992-2002) and graduates of 3 family medicine residencies (1978-2002). Graduates' (N = 656) practice locations were documented using specific federal designations relating to health professions shortages and rurality. RESULTS: Overall, 83% of family medicine residency and 80% of nurse practitioner graduates selected practice locations in areas with medically underserved or health professions shortage designations; 48% of family physicians and 38% of nurse practitioners were in rural areas. CONCLUSIONS: Graduates who study in an educational setting with a mission-driven commitment to rural and community health and who participate in curricular activities designed to increase their experience with rural and underserved populations choose, in high numbers, to care for these populations in their professional practice.

Appalachian Region↗
PubMed2002

Recruiting physicians and long-term viability: perspectives of physicians and practice managers.

As outcome measures become more informative, staffing by high quality physicians becomes more important to the competitive position of care providers. Success in physician recruiting is, therefore, a key to the long-term success and viability of care providers. Perceived problems in recruiting physicians led the Cincinnati Academy of Medicine to sponsor a study in the agreement between physician recruiters and physicians on the relative priority of factors affecting physicians' choices of practice location. The study found general agreementon mostof the 15 factors considered. Disagreementexisted, however, on the importance of salary and benefits and the importance of physicians' ability to make management decisions.

Career Choice↗
PubMed1993

Recruitment, retention, and follow-up of graduates of a program to increase the number of family physicians in rural and underserved areas.

BACKGROUND: To help address the geographic and specialty maldistribution of physicians, Jefferson Medical College initiated the Physician Shortage Area Program (PSAP) in 1974. This unique program, which combines a selective medical school admissions policy with a special educational program, has been shown to be successful in increasing the number of family physicians in rural and underserved areas, but it is not known whether they remain in this type of practice. METHODS: Graduates of the PSAP were tracked longitudinally and compared with their non-PSAP classmates. Information was obtained about the retention of family physicians in rural areas and areas with a physician shortage over the previous five years, the geographic and specialty choices of more recent graduates, and the recruitment of applicants into the program. RESULTS: Of the 47 PSAP graduates from the classes of 1978 through 1981, reported on earlier, the number who combined a career in family medicine with practice in a rural area or one with a physician shortage remained unchanged, although there was substantial attrition among non-PSAP graduates practicing family medicine in rural (32 percent) and underserved (40 percent) areas. Among the 101 PSAP graduates of the classes of 1982 through 1986, the results were similar to those for the first four classes. Overall, PSAP graduates from the classes of 1978 through 1986 were approximately four times as likely as non-PSAP graduates to practice family medicine (55 percent vs. 13 percent), to practice in a rural area (39 percent vs. 11 percent), and to practice in underserved areas (33 percent vs. 8 percent). They were approximately 10 times more likely to combine a career in family medicine with practice in a rural (26 percent vs. 3 percent) or underserved (23 percent vs. 2 percent) area. Overall, 85 percent of PSAP graduates were either practicing a care specialty or practicing in a rural or small metropolitan area or one with a shortage of physicians. In parallel with national trends, the number of applicants and matriculants to the program decreased during the past decade, so that the percentage of available places filled decreased from 97 percent to 33 percent. However, there has been a recent increase in the number of applicants and matriculants. CONCLUSIONS: The results of this study indicate that the PSAP was successful in increasing the number of family physicians in rural and underserved areas as well as in retaining them. This suggests that medical schools can have a substantial influence on the distribution of physicians according to specialty choice and the geographic location of their practices, principally through admission criteria.

Family Practice↗
PubMed1998

Emergency medicine resident choice of practice location.

STUDY OBJECTIVE: To describe the geographic distribution of practice locations for 1995 emergency medicine residency graduates and factors that are important to residents in their choice of practice location. METHODS: Self-administered questionnaires were distributed to Emergency medicine residents who graduated in 1995. The survey ascertained practice city and state, resident employment characteristics, and the importance of factors that influenced the residents' selection of employment. RESULTS: Eighty-six of 87 programs and 441 (69.4%) of 635 eligible residents participated. Forty-three percent of graduates chose to practice in the city or metropolitan area in which they trained; 46% of these had no personal tie to the area before their residency training. Liking the city was cited as being more important (P<.001) than other factors in picking practice location. Group personality and coworkers' credentials were more important (P< or =.01) than contract and salary arrangement. Twenty percent of respondents were not practicing in the city or area of their first choice. CONCLUSION: Residency training location, regardless of prior ties to the geographical area, appears to be a major factor in the choice of practice location of emergency medicine residency graduates. Coworkers' personalities and credentials are more important factors in job selection than salary and employment arrangements.

Adult↗