Retention of primary care physicians in rural health professional shortage areas

Am J Public Health. 2004 Oct;94(10):1723-9. doi: 10.2105/ajph.94.10.1723.


Objectives: We tested the assumption that average job retention duration is shorter for physicians in rural health professional shortage areas (HPSAs) than for physicians in rural non-HPSAs.

Methods: In 1991, we surveyed nationally representative samples of primary care physicians who recently had moved to rural HPSAs and non-HPSAs who were without service obligations. We resurveyed these physicians in 1996 and 1997 to learn of any job changes.

Results: Physicians in rural HPSAs (n=308) demonstrated retention similar to that of the non-HPSA cohort (n=197) (hazard ratio for leaving=1.28; 95% confidence interval=0.97, 1.69; P=.08), even with adjustments for group demographic differences (P=.24).

Conclusions: Average retention duration for generalist physicians in rural HPSAs is identical to or slightly shorter than for those in rural non-HPSAs. Poor recruitment is likely to be the principal dynamic underlying local rural shortages.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Chi-Square Distribution
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Medically Underserved Area*
  • Personnel Turnover / statistics & numerical data*
  • Physicians / supply & distribution*
  • Primary Health Care*
  • Proportional Hazards Models
  • Rural Health Services*
  • Surveys and Questionnaires
  • United States
  • Workforce