ArticleCanadian family physician Medecin de famille canadien
Why do family physicians stay in rural practice? National survey of Canadian primary care clinicians who have stayed or left.
Article in Canadian family physician Medecin de famille canadien. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine the variables associated with family physicians staying in or leaving rural practice.
designSurvey asking family physicians currently and recently practising in rural settings in Canada about their experiences.
settingCanada.
participantsAll family physicians currently practising in rural settings and those who had left rural settings within the previous 5 years.
main outcome measuresFactor analysis was used to condense a range of variables, and comparative analyses were carried out to identify those variables that differentiated between the 2 groups. Multivariable logistic regression was used to quantify their relative importance.
resultsA total of 1023 completed surveys were received, including 96 from family physicians who had moved from rural to nonrural practice within the past 5 years. Variables associated with leaving rural practice included some that could be modified through health system planning: lack of schedule control, lack of Royal College of Physicians and Surgeons of Canada specialist visits to the community, working in a rural hospital emergency department, and having a return-of-service agreement. One variable over which the health system has little control, the effect of the practice location on physicians' children, was also identified.
conclusionIn this first national study of retention of family physicians in rural areas, 5 variables that predict the likelihood of physicians leaving rural practice were identified. At least 4 could be modified through policy-makers, professional groups, health administrators, communities, and academic institutions together planning long-term, coordinated, and sustainable solutions that support the retention of rural physicians.
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