Objective: The goal of this research was to understand factors that affect future practice intentions of physicians who practise in rural and underserviced areas. The following 2 research questions are answered: "How many physicians in Northwestern Ontario intend to leave their practice in 5 years?" and "What is the association between professional, personal/family and community factors in physician satisfaction and intention to stay in practice?"
Methods: Between September and October 2004, physicians practising in Northwestern Ontario were mailed a survey measuring professional, personal/family and community satisfaction as well as future practice intentions. Future practice intention (question 1) was analyzed through a frequency distribution, while the factors that influenced intention (question 2) were analyzed using a 3-step process: a factor analysis, the creation of scales and a logistic regression. The themes of the scales emerging from the factor analysis were family/community, time, professional support and efficacy, and sense of belonging and appreciation. The means of these 4 scales were entered into a logistic regression model along with demographic variables that were independent predictors of future practice intention.
Results: Three hundred and twenty-eight physicians were sent the survey. After 3 consecutive mailings, the response rate was 61.3% (n=201). Over two-thirds of Northwestern Ontario physicians intended to remain in practice in 5 years; however, most of these physicians were from Thunder Bay, the only city (100 000+ population) in Northwestern Ontario. Physicians were significantly more likely to intend to stay in practice if they were younger, practised in Thunder Bay and scored higher on the family/community scale.
Conclusion: These findings underscore the importance of addressing family and community factors, as opposed to strictly professional factors, in future retention initiatives.