Document Type

Article

Publication Date

8-22-2008

Abstract

Introduction: While 20% of Americans live in rural areas, less than 10% of the nations physicians practice there. In New Mexico, 60% of the population lives in rural communities although only 40% of state's health care workforce can be found there. Federal and state governments, medical schools, and private foundations have all studied and attempted to find ways to train, recruit, and retain more primary care clinicians to rural areas. Many rural recruitment programs are predicated upon older research and investigations involving medical students and physicians from earlier generations. This study attempts to update and determine if there are new or overlooked factors that draw providers to primary care in rural communities. Methods: Surveys were sent to 600 primary care physicians and nurse practitioners over the course of Spring and Summer, 2007. Respondents were asked a series of open-ended questions along with rating scaled items about factors and characteristics that drew them to practice in their chosen community. Respondents samples were stratified into rural versus urban and physician versus nurse practitioners. Analysis was aimed at determining significant differences between groups using ANOVA, correlations, and contingency table analysis. Results: As expected, rural physicians and nurse practitioners showed different profiles of motivations and characteristics compared to urban providers, and physicians and nurse practitioners showed somewhat different profiles, although these differences ranged from moderate large to small in magnitude. We replicated previous findings that show that providers are more likely to practice in a rural areas if been born, raised, or trained in a rural area. Conclusions: This study supports earlier determinations that previous residence or training in rural milieu is associated with later practice in such areas. Modest differences in factors reported by rural compared to urban providers to influence their decisions to select their current practice communities may enable additional insight into provider employment decisions that may enhance the ability to recruit rural providers. However, findings may be unique to New Mexico, given that this state is an underserved state in its entirety.'

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