Clinician retention in medically underserved areas

Introduction

The Native Hawaiian Health Scholarship Program (NHHSP) of Papa Ola Lokahi is a service obligated scholarship that aims to decrease the health disparities of Native Hawaiians by providing educational, cultural and professional training. NHHSP awards scholarships in 16 primary care fields and offers academic counseling, job readiness skills and job placement. The impact of NHHSP in medically underserved areas (MUA) is a culturally-competent, Native Hawaiian workforce. The NHHSP program model incorporates Native Hawaiian values to support the suitability, satisfaction and retention of scholars.

Methods

In 2006, 104 scholars performing or completed their service obligation were surveyed. Fifty four (52%) surveys were returned and analyzed to determine what factors influence clinician retention.

Findings

Seventy-three percent of the scholars surveyed continued employment after completing their service obligation for an average of 2.8 years (post service). Scholars with higher self ratings of Native Hawaiian Values are significantly more likely to continue working in MUA. Scholars rated their work sites significantly higher in the following site characteristics: Native Hawaiian values and preparation to perform administrative duties. The data also suggests trends of higher retention rates for clinicians with childhood years or other experience in rural areas. There was a higher rate of attrition at the end of service among those raised in Urban and/or Suburban areas.

Conclusion

Clinicians are more likely to continue employment in positions when their work is aligned with values and leadership opportunities are available. Health Administrators who recruit staff best suited for the population to be served and respond to what staff identifies as important job characteristics may experience better retention within their workforce.