Retention of Primary Care Physicians in Rural Health Professional Shortage Areas

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.