Rural physicians and their spouses: Factors that influence retention in central appalachia

Numerous Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas/Populations (MUA/Ps) in rural central Appalachia have faced physician shortages for decades. Physician shortages create challenges to health administrators, physician recruiters, and residents in these rural communities. Previous studies show the influence of the spouse on recruitment, but there is limited research on the influence of the spouse on rural physician retention. For the scope of our study, we hypothesize that the sociocultural integration of the spouse is more important than that of the physician in the decision to remain or leave the rural community. In addition, we hypothesize the spouse also possesses differing viewpoints on the factors that influence retention. Results from a preliminary study conducted in 2011, using paired t-tests to assess differences between the physician and the spouse, suggested the spouse may view certain factors as more or less influential to retention compared to the physician. A focus group conducted in 2012 supported this supposition. Traditional hard copy questionnaires were distributed to the physicians of Appalachian Regional Healthcare (ARH), a not-for-profit rural hospital system in southeast Kentucky and southern West Virginia. This study focuses on retention and spousal influence. 460 printed surveys (230 physician surveys and 230 spouse surveys) were distributed at 8 out of 10 hospitals in the ARH system. Developing and refining strategies that focus on the needs of the spouses might improve the success of both recruitment and retention efforts of physicians to rural central Appalachia.