Rural Retention for Health Care Professionals

Recent concerns over the shortage of qualified medical professionals in rural areas across the United States has spawned numerous studies into the factors of recruitment and retention of qualified healthcare professionals. One study focused on factors that would keep, or draw health professional graduates back into rural areas. Among the most salient factors, loan forgiveness, rural training programs and the “desirability of rural locations” topped the responses (Daniels, et al. 2007).

A recent article focused more on the “3D conversation” and the marriage/family factor used to recruit and retain health professionals in rural practice. According to Richard P. Finnegan, the 3D conversation means that the physician is actually present with the interviewing committee, touring the town. This strategy employs a technique called “realistic job preview” or RJP. The idea is to make explicitly clear the absolute worst parts of the job so that they can screen themselves out. This includes but is not limited to a couple of steps that Finnegan outlined:

“But most important, we decided, was to tell the doctor these two things:

  1. What types of doctors have enjoyed the area in the past and which left early, without holding back any cause-effect reason including lifestyle, loneliness, spouse disapproval, weather…anything.
  2. Tell the doctor the minimum number of years she should plan to stay in order to be fair to your community; this is not a binding commitment from either side but instead an expectation that should be clear.”

The challenge, then, is to do a clear, concise assessment of the pro’s and cons of working within a particular rural area. The clearer the picture the would-be rural health care professional has of his or her potential place of employment — the culture, the attitude of the people, the types of individuals that do well there — the better the retention of said professional will be.

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