University of Louisville

The Factors that Influence Clinicians to Choose Rural Settings to Deliver Health Services

Presenter Information

Julia MattinglyFollow

Grade Level at Time of Presentation

Senior

Major

Rural Health Policy (Liberal Studies), Political Science

KY House District #

10

KY Senate District #

5

Department

Health Management & Systems Sciences

Abstract

Years before the COVID-19 pandemic brought on a health care shortage in the United States, its rural areas were already struggling to obtain and attract primary care medical practitioners. The federal government has designed many programs with the intent of exposing clinicians to life in rural areas, but few have been successful at keeping medical practitioners in the long-term. Clinicians who are recruited to rural areas via loan repayment programs or other short-lived incentives often leave after only a few years.

In order to learn more about this long-running health policy problem, we set out to study the factors that influence clinicians to choose to work in rural health care. This qualitative research was conducted through ten audio-recorded interviews with rural clinicians throughout the state of Kentucky. Interviews were only conducted with providers who practice in a Kentucky county with 50,000 people or less. Participants were asked seven questions pertaining to their experience as a rural health provider, their medical training, the factors that influenced them to practice in a rural community, and if they participated in any financial incentives to come there.

We ultimately found that the strongest influences for practicing in a rural community were: the strong patient-provider relationship that comes from the closeness of rural communities; provider preference to rural lifestyle; a positive rural training experience the provider had during their schooling; and provider preference to flexibility and diversity in their practice. Based on our results, financial incentives have little impact on a clinician’s decision to practice in a rural area, and the decision is more weighted in their personal lifestyle preference and values. Thus, policies should be implemented to better expose medical students to rural environments during their clinical training and residency.

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The Factors that Influence Clinicians to Choose Rural Settings to Deliver Health Services

Years before the COVID-19 pandemic brought on a health care shortage in the United States, its rural areas were already struggling to obtain and attract primary care medical practitioners. The federal government has designed many programs with the intent of exposing clinicians to life in rural areas, but few have been successful at keeping medical practitioners in the long-term. Clinicians who are recruited to rural areas via loan repayment programs or other short-lived incentives often leave after only a few years.

In order to learn more about this long-running health policy problem, we set out to study the factors that influence clinicians to choose to work in rural health care. This qualitative research was conducted through ten audio-recorded interviews with rural clinicians throughout the state of Kentucky. Interviews were only conducted with providers who practice in a Kentucky county with 50,000 people or less. Participants were asked seven questions pertaining to their experience as a rural health provider, their medical training, the factors that influenced them to practice in a rural community, and if they participated in any financial incentives to come there.

We ultimately found that the strongest influences for practicing in a rural community were: the strong patient-provider relationship that comes from the closeness of rural communities; provider preference to rural lifestyle; a positive rural training experience the provider had during their schooling; and provider preference to flexibility and diversity in their practice. Based on our results, financial incentives have little impact on a clinician’s decision to practice in a rural area, and the decision is more weighted in their personal lifestyle preference and values. Thus, policies should be implemented to better expose medical students to rural environments during their clinical training and residency.