Is the time right to re-locate?
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Humans↗
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Results for “Professional Practice Location”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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Students' expected practice locations and their tolerance of ambiguity.
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Career Choice↗
Career differences between primary care and traditional trainees in internal medicine and pediatrics.
OBJECTIVE: To assess the relation of Primary Care Residency Training to career choice, board certification, and practice location of internists and pediatricians. DESIGN: Cohort study with up to 8 years of follow-up. SETTING: The United States. PARTICIPANTS: The 17,933 residents trained in all internal medicine (13,750) and pediatrics (4,183) residency programs between 1977 and 1982 were studied using information from the National Resident Matching Program, the AMA Physician Masterfile, the Area Resource File, and a telephone survey. MEASUREMENTS: Career choice, board certification, and practice location were studied in relation to five explanatory variables: type of residency (primary care or traditional track), gender, year of medical school graduation, educational orientation of the teaching hospital, and medical school prestige. MAIN RESULTS: Graduates of primary care residency training programs chose careers in generalist primary care significantly more often than did graduates of traditional tracks in both internal medicine (72% compared with 54%) and pediatrics (88% and 81%, respectively; P less than 0.001 for both values). Board certification rates in internal medicine were statistically higher for graduates of primary care training programs (80%) than for graduates of traditional programs (76%, P = 0.002) but were not statistically significant for both groups of pediatric graduates. Graduates of primary care programs in pediatrics and internal medicine practiced in medically less served communities more often than did graduates of traditional programs. CONCLUSION: Graduates of primary care residency training programs in internal medicine and pediatrics differ from graduates of traditional residency programs in career choices, board certification rates, and practice locations.
Career Choice↗
The emerging profile of dental manpower in Oklahoma. 2. Tulsa county.
This is the second report of a three part study. Part I focused upon the dental manpower profile of Oklahoma County between the years 1972-1989. Part II emphasizes the dental manpower profile of Tulsa County. Part III, will be inclusive of the dental manpower profile of all other Oklahoma counties. In all phases of the study, data has been assessed for general practitioners, specialists, full-time general practice dental faculty, full-time specialist dental faculty, and public health dentists. The demographic data analyzed in Part I, revealed an increasing average of the dentists from 45.33 years of age in 1972 advancing to 48.83 years of age in 1989 for Oklahoma County. The data presented in Part II documents that in Tulsa County there was an increase in age from 45.68 in 1972 to 50.60 in 1989. Trends in location of dental school education, demonstrated that the University of Oklahoma College of Dentistry is currently the primary resource for the dental manpower pool in Tulsa and Oklahoma Counties. Changes in the dental manpower pool indicate a downward turn in the percentage of dentists choosing to locate in either Tulsa or Oklahoma County.
Dentistry↗
Environment, location and styles of practice.
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Cost-Benefit Analysis↗
How long do general practitioners remain in any one location?: Regional and urban size variations in the turnover of foreign and New Zealand doctors in general practice, 1976-90.
Studies of doctor location have, for the most part, focused on geographic variations in access to care, rather than the continuity of care provided at different locations. This paper examines regional and city size variations in turnover rates in general practice and shows that they are highest in the southern and most rural regions of New Zealand. However, an unexpected finding was that no significant differences occurred by doctor origin. While more foreign than New Zealand medical graduates have located in rural New Zealand, similar turnover rates between the two groups indicates that their presence has not resulted in any improvement in the continuity of care provided.
Cohort Studies↗
The general practice contract scheme: was it targeted?
OBJECT: to determine whether the contracted general practices were situated in areas of greatest health need. METHOD: the health and equity index was used to determine the level of health need of the geographical location of the contracted practices. RESULTS: the health and equity index for the urban contracted practices showed a high level of health need. In the rural practices, the census area unit in which the practices were located showed a high level of health need, however when surrounding census area units were considered, they were located in areas of average health need. CONCLUSION: the general practice contract scheme was well targeted.
Delivery of Health Care↗
Determinants of dentists' geographic distribution.
Practice location may have greater economic importance today for dental students and dentists who are considering relocation and/or expansion to new sites than in the past. Yet, a literature review easily leads to the inference that practice location decisions are far too complicated and individualistic for there to be any systematic pattern of dentists' geographic distribution. This paper specifies and estimates an economic model that attempts to explain the distribution of dentists in particular market areas in the state of Connecticut and to test the hypothesis that the distribution, rather than exhibiting randomness, adheres to the prediction of theory. The findings show that the geographic distribution of dentists is significantly related to a few key variables. Given these results, and because this model can be applied to other areas and uses data that are readily available for any market area, it may be useful for educators involved in helping dental students with their practice location decisions.
Capital Financing↗
The influence of medical school clinical experiences on career preferences: a multidimensional perspective.
This study examines the multiple influences of medical school clinical experiences on student career preferences. The analysis of responses to pre-clerkship and post-clerkship questionnaires administered to the 1983 graduating class of a well-established medical school in the Great Lakes region of the United States indicates significant changes in career plans: away from primary care practice towards the surgical specialties; away from office-based practice towards clinical practice in a university medical center; and away from practice in small towns and communities towards locations in larger cities. These changes in the last 2 years of medical school appear to stem from an increased exposure to research and sophisticated medical technology. If allowed to continue, this trend in medical education will contribute further to the clinical specialty and geographic maldistribution problems of medicine in the United States.
Career Choice↗
Management of incipient caries in young adults. Dentists state their preference.
Survey finds general dentists in upstate New York use variety of treatment modalities to manage questionable or early caries in their young adult patients. The age of the dentist appears to be a factor in treatment selection, as is location of practice.
Adult↗
Practice mobility among young physicians.
This study examines practice mobility among young physicians, based on a large nationwide 1987 survey of physicians under age 40 years and in their second through fifth years of practice. Averaged across all physicians, there is a 10% to 12% chance of changing practices for each of the first 3 years, and about one in three physicians changes within the first 5 years. While the most common transition is from employee to self-employed practices, many practice changes are within employment type. Those starting in a self-employed solo practice are least likely to change practices, while those starting as HMO employees are most likely to change. Multinomial analysis of practice change choices reveals some specialty-specific differences in these choices, as well as the effects of experience, schooling, race, sex, debt, family constraints, and locational preferences. High debt is a factor in practice changes, but neither competition nor discrimination against minorities appear to play significant roles.
Adult↗
Medical specialists' choice of location: the role of geographical attachment in Norway.
The relation between current place of work (area of the country) and factors that might possibly represent doctors geographical attachments was studied in a sample of 322 Norwegian medical specialists. Location of hospital residency, age and geographical origin of spouse were associated with current location. Geographical attachment seems to influence doctors' locational choices from start of medical school until the end of their residency. The probability that a doctor shall locate in peripheral areas may increase from less than 10% to more than 50% if the doctor has the residency training in the periphery. Hence, favoring entrance to medical schools of students from the underserved areas, and location of graduate and postgraduate medical training in the underserved areas, as far as it is feasible while still maintaining medical standards, is suggested by the study.
Adult↗
Factors in the physician practice location puzzle: a survey of New York State residency-trained family physicians.
BACKGROUND: For the past 5 years fewer medical students have selected primary care specialties, and one-third of all physicians have indicated they will move in the next 5 years. These two factors make family physicians one of the most recruited specialties in medicine. METHODS: A questionnaire about practice profiles and factors that have an impact on a physician's location decision was mailed to all physicians who graduated from New York State family medicine residencies between 1970 and 1989. Data from completed responses were analyzed by year of graduation from residency, community size, and whether the responder remained in New York State or chose to locate outside New York State. RESULTS: There were 711 (46 percent) physicians who responded. The number of minorities remained stable at 14 percent during these years, but women graduates increased from 12 percent to 21 percent. The graduates in the 1980s, when compared with those in the 1970s, were more likely to be salaried, make less money, and to believe employment for the physician's spouse to be important in practice location. The 38 percent of responders from communities of fewer than 25,000 were less likely to be salaried, were more likely to practice in a group, worked more hours, offered a broader range of services including obstetrics, made less money, and placed less importance on availability of hospital consultants. Extended family, previous negotiated obligations, and geographic or climate issues were the reasons 64 percent of out-of-state responders gave for leaving New York. Spouse's opinion, hospital consultants, hospital services, colleague interaction, and after-hours coverage were most frequently rated as important factors for family physician practice location. CONCLUSIONS: Factors important in attracting new physicians to a community include the spouse's opinion, institutional and colleague support, and lifestyle issues.
Adult↗
Which medical schools produce rural physicians?
OBJECTIVE: To examine the hypothesis that medical schools vary systematically and predictably in the proportion of their graduates who enter rural practice. DESIGN: The December 1991 version of the American Medical Association Physician Masterfile was used to examine the rural and urban practice locations of physicians who graduated from American medical schools between 1976 and 1985. Selected characteristics of the medical schools--including location, ownership, and funding--were linked to the Physician Masterfile. MAIN OUTCOME MEASURES: The percentage of the graduates from each medical school who were practicing in rural areas in December 1991, disaggregated by physician specialty. RESULTS: Of the practicing graduates from our study, 12.6% were located in rural counties; family physicians were much more likely than members of other specialties to select rural practice, particularly in the smallest and most isolated rural counties. Women were much less likely than men to enter rural practice. Medical schools varied greatly in the percentage of their graduates who entered rural practice, ranging from 41.2% to 2.3% of the graduating classes studied. Twelve medical schools accounted for over one quarter of the physicians entering rural practice in this time period. Four variables were strongly associated with a tendency to produce rural graduates: location in a rural state, public ownership, production of family physicians, and smaller amounts of funding from the National Institutes of Health. DISCUSSION: The organization, location, and mission of medical schools is closely related to the propensity of their graduates to select rural practice. Increasing policy coordination among medical schools and state and federal governmental entities would most effectively address residual problems of rural physician shortages.
Career Choice↗
The impact of civil disturbances on the migration of physicians: the case of Lebanon.
This report examines the impact of war on the migratory patterns of physicians in Lebanon, a country with ever-raging civil disturbances for the past 15 years. The data base included two cohorts of medical graduates of the American University of Beirut: the 1960 through 1969 cohort, whose education and training were completed before the onset of the civil war, and the 1970 through 1979 cohort, who was exposed to the turmoil in Lebanon during either their study or their residency training. Between- and within-cohort comparison of their locations 5 years after graduation was made. Findings suggest that there is an association between civil instability and migration. This relationship could not be explained by possible confounders like nationality, training abroad, and board certification. On the contrary, factors that potentiated migration in the earlier cohort before the onset of the war were less frequent in the latter cohort with the increased tendency to migrate.
Career Choice↗
The influence of practice type, region, and age on treatment recommendations for primary teeth.
The purpose of this study was to investigate dentists' treatment recommendations for interproximal surfaces of primary molars based on the type of practitioner (general dentist or pediatric dentist), geographic location, and age of practitioner. Simulated cases, which included histories and pictures of bite-wing radiographs, were mailed to a random sample of 2000 general dentists and 1000 pediatric dentists. Dentists were asked to select their treatment recommendations for eight cases involving the interproximal surface of a specified primary molar. The return rate was 42% (1245) overall, with 36% (723) from general dentists and 52% (522) from pediatric dentists. An amalgam restoration was recommended most often for these eight cases. Dentists in the age 60+ category and pediatric dentists were more likely to recommend treatment for smaller interproximal lesions. Composite resins were recommended infrequently; however, dentists in the 60+ age category and dentists in the Northeast and Southwest were somewhat more likely to recommend composite resin than younger dentists, or dentists in other geographic locations. Dentists in the 40-49 age range, pediatric dentists, and dentists in the Southwest were the most likely to recommend stainless steel crowns. These simulated cases demonstrate differences and similarities in the treatment recommendations for interproximal lesions on primary molars based on age, practice type, and region.
Adult↗
The role of local hospitals in physician rural location decisions.
This study has two objectives. First, it identifies how much the presence of community hospital beds adds to the stock of physicians practicing in nonmetropolitan counties. Second, it estimates the impact hospital closures or other reductions in beds have on the net flow of physicians into rural counties. The study relies primarily on data from the 1981 and 1986 Physician Masterfiles of the American Medical Association. We find that hospital bed reductions and closures essentially do not affect the availability of physicians--they have apparently already left by the time the downsizing occurs. Further, population change and the number of physicians already in the county determine for the most part the entry or exit of physicians.
Career Choice↗