Factors influencing retention of rural Pennsylvania family physicians.

BACKGROUND Rural areas suffer from a lack of primary care physicians. Efforts to retain physicians should focus on modifying or changing attributes of rural practice that are considered by physicians to be undesirable. A practice support outreach program (PSOP) is one initiative expected to enhance retention in rural areas by addressing negative aspects of rural practice. The purpose of this study was to assess factors related to satisfaction and retention of family physicians to develop and implement a PSOP in rural areas of Pennsylvania. METHOD In 1993 a mail survey was conducted on a convenience sample of 398 family physicians practicing in 39 counties in Pennsylvania. RESULTS Twenty percent of respondents were considering leaving rural practice. Bivariate analyses indicated that professional isolation, lower reimbursements, and sharing on-call with only 1 other physician were associated with physician's reasons for considering leaving rural practice. A multiple logistic regression revealed that sharing on-call rotation with only 1 other physician and having a solo practice were significant influences in considering leaving rural practice. CONCLUSIONS Findings suggest support strategies that minimize perceptions of professional isolation and policy efforts that address reimbursement differentials and compliance issues are needed to minimize many complaints of rural family physicians.