I’m recruited - why should I stay? A case study of physician retention in an underserved area

Abstract

Introduction: Recruiting a physician to a rural area is expensive.  However, it is even more costly and devastating to a community when a practitioner leaves. Our team aimed to identify factors that may influence physicians' decisions to remain in a rural community, as well as factors that may cause them to leave, and to gather real-world perspectives on what is needed to improve the health of their community.

Methods: This case study employed a qualitative design, utilizing a 13-item survey with multiple-choice and narrative response options, which was sent to physicians in rural areas throughout New Mexico. The first ten questions were demographic indicators. The remaining questions assessed what drew respondents to the area and why or why not they would consider leaving this location. Short-answer responses were categorized as intrinsic or extrinsic and then grouped into common themes.

Results: We achieved a response rate of 33.4%. Physicians were primarily drawn to practice in rural New Mexico for extrinsic reasons, with geographical location being the most common cause, followed by financial incentives. There were no intrinsic reasons for remaining.

Conclusions:

In New Mexico, 32 of the 33 counties are considered medically underserved. Retaining physicians to practice in these areas is vital. This case study demonstrates that the intrinsic motivations that initially draw physicians to practice in these rural areas may be overpowered by the extrinsic factors influencing their decision to leave.