216548 Recruitment and retention of primary care providers at community health centers: Consequences of health care reform

Sunday, November 7, 2010

Judith Savageau, MPH , Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA
Linda Cragin, MS , MassAHEC Network, University of Masschusetts Medical School, Shrewsbury, MA
Joan Pernice, RN, MS , Clinical Affairs Department, Massachusetts League of Community Health Centers, Boston, MA
Donna E. Johnson, MSW, LICSW , Division of Primary Care and Health Access, Massachusetts Department of Public Health, Boston, MA
Joan Bohlke, MS , MassAHEC Network, University of Masschusetts Medical School, Shrewsbury, MA
Julia Dyck, MPA/H , Division of Primary Care and Health Access, Massachusetts Department of Public Health, Boston, MA
Warren J. Ferguson, MD , Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA
Background: When Massachusetts implemented universal health insurance coverage, community health centers (CHCs) were on the primary care front line. The CHC primary care physician (PCP) shortage heightened as many community-based physicians closed their practices to new patients. This study's objective was to characterize Massachusetts' current CHC PCP workforce and identify factors related to preparedness, recruitment and retention.

Methods: 572 PCPs at 62 CHCs were invited to complete an on-line survey asking about physician sociodemographic and practice characteristics, medical education training, and factors related to preparedness, recruitment and retention.

Results: With 58% responding, CHC PCPs were predominantly female, white, non-Hispanic, working full-time, speaking 1+ additional non-English language, and in practice an average of 13 years. 16% were foreign-trained; 22% had medical education debt over $100,000; 60% were hired since 2000; and 48% were current or former participants in visa/loan repayment programs. Work/life balance (94%); skilled staff or other operational supports (85%); and support for professional development (82%) contributed to retention. Mixed-model regression analyses identified factors related to the likelihood of PCPs continuing to work in a CHC in the next five years including: female providers; urban practice; 10+ years of practice; preparation during training to work in a CHC; and high satisfaction with compensation and with the CHC's mission and diversity of patients.

Conclusions: With the nation's focus on health care reform, these results indicate opportunities to strengthen the CHC PCP pipeline. Addressing compensation is one strategy; equally important are PCP-identified priorities to create and maintain a strong and sufficient primary care workforce for underserved populations.

Learning Areas:
Administration, management, leadership
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Participants will be able to: 1. Describe the key factors related to recruitment and retention of primary care providers within the community health center setting. 2. List physician sociodemographic and practice characteristics related to both recruitment and retention processes in light of health care reform practices ongoing. 3. Assess implications of survey’s findings for primary care practice.

Keywords: Community Health Centers, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience in research related to public health policy, especially at the statewide level, and have worked on numerous projects which impact workforce development efforts in primary care and meeting the needs of underserved populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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