How physicians’ anticipated retention within urban and rural HPSA practices varies with their assessments of their work and jobs

Purpose Physician turnover within Health Professional Shortage Areas (HPSAs), as in all settings, frequently occurs when physicians are dissatisfied with aspects of their work and employment. This study evaluates how physicians’ assessments of 6 aspects of their work and jobs relate to whether they anticipate remaining in their urban and rural HPSA practices for more than 2 years, and assesses differences for physicians in urban and rural HPSAs. Methods Survey data on physicians’ assessments of 6 facets of their work and jobs were obtained from 747 physicians working in urban HPSAs and 355 in rural HPSAs across 33 states (54.9% response rate). Separate hierarchical logistic regression models identified work and job factors independently associated with anticipated retention beyond 2 years for each group. Z ‐tests assessed differences between the urban and rural models in odds ratios for each work and job factor. Findings Anticipated retention was more likely in both urban and rural HPSAs when physicians felt they had good administration, they felt connected and supported at work, and work felt meaningful, and likely also if they provided their desired range of services, but in neither setting if they felt adequately compensated or not. Anticipated retention in rural but not urban HPSAs was more likely when physicians had a good work‐life balance. Conclusions Physicians’ anticipated retention within HPSAs is associated with how they feel about various aspects of their work and jobs. These aspects of work and jobs are generally but not exactly the same in urban and rural HPSAs.