MedicalResearch.com Interview with:
Matthew R. McGrail, PhD
School of Rural Health
Churchill, Victoria Australia
MedicalResearch.com: What is the background for this study?
Response: Rural populations continue to experience relative shortages of the supply of primary care physicians, with associated links to poorer health. Although considerable research has identified factors that facilitate or impede supply of physicians in rural areas, macro-level empirical evidence of observed rural mobility of physicians – notably, which are more likely to move and why – is limited.
Improved understanding of mobility and nonretention of rural physicians is important because of its impact on training and workforce policy, and resultant physician supply to both the origin area (ie, the location from which the physician moved) and to the destination area (ie, the location to which the physician has moved). The cost of mobility and staff turnover can be large, both in direct costs but also in terms of service quality and continuity to the community.
In our study, we aimed to describe the geographic mobility patterns of rural primary care physicians. This evidence will provide stronger understanding of the factors behind the observed mobility and nonretention of rural primary care physicians.
MedicalResearch.com: What are the main findings?
Response: We found that increased rural primary care physician mobility was strongly linked with interrelated county-level characteristics of poorer physician supply, less population, and lack of a hospital, but area level economic and demographic factors had little impact. Overall, biennial mobility rates between counties of different rurality varied between 17% (for physicians aged 45 or younger) and 9% (for those aged 45-64). Individual physicians more often left rural areas if they were female, international medical graduates, not of rural origin, or working in counties adjacent to metropolitan areas.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Increasing rural workforce supply and retaining the existing rural physician workforce remain key issues of the United States. Rural health workforce planners and policymakers must be cognizant of these key factors to more effectively target retention policies and to take into account the additional support needed by these more vulnerable communities.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Practice location decision making of physicians is complex, and this study does not address many of the contributing factors. Emerging evidence suggests the early-career training experience, including student selection, rural exposure and training pathways are vitally important to rural practice outcomes; however, this study did not focus on these aspects. Furthermore, a more nuanced understanding of the influence of both career and family stages on practice location is needed.
MedicalResearch.com: Is there anything else you would like to add?
Response: Primary care physician workforce supply disparities between rural and metropolitan areas remain a major problem nationwide. Rural populations deserve to have equitable access to primary care physicians.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Matthew R. McGrail, Peter M. Wingrove, Stephen M. Petterson, and Andrew W. Bazemore
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