Background: Rural hospitals continue to struggle to recruit physicians. Examining trustee/board member perceptions of their community's strengths and challenges related to physician recruitment may provide insight on how to sustain an effective workforce in these facilities. Objective: The purpose of this study is to identify similarities and differences between critical access hospital (CAH) trustee/board members' perspectives on factors important to physician recruitment compared to their hospital administrators and physicians practicing in their facilities. Methods: The CAH Community Apgar Questionnaire (CAH CAQ) was expanded to include trustee/board member participation in Iowa. Online survey methods were used to compile information from trustees/board members, hospital administrators and physician from participating CAHs recruited by the Iowa Hospital Association. Results: A total of 16 Iowa CAH communities participated in the project in 2015. There were 17 administrators, 39 physicians and 23 board members respondents for a total of 79 respondents. Significant differences were found between trustee/board members and hospital administrators ratings on CAH CAQ factors loan repayment and transfer arrangements. Trustee/board members and physicians showed significant differences on scores for the CAH CAQ class factor hospital/community support and on factor ratings for teaching, administration, hospital sponsored continuing medical education and welcome and recruitment programs. Discussion: This study has identified commonalities and differences in how rural hospital trustee/board members and the administrators and physicians who work at their facilities view community strengths related to physician recruitment. Analyzing and discussing the areas of consensus and differences of opinion could help develop more effective physician recruitment strategies for these communities.
Objective: Health information technology (HIT) in rural settings has considerable potential to address rural health needs such as cost, access, and efficiency. This study contrasts the use of technology by Idaho rural physicians to identify differences in technology usage over time. The study includes information on technology factors such as internet databases, internet journals, e-publications, teleconferencing, electronic health records (EHRs) for patient care, and electronic physician education materials. Methods: Surveys focused on the broad experience of practicing rural medicine were administered to rural physicians in Idaho who practiced in counties containing less than 50,000 people. Identical surveys were sent out in 2007 and again in 2012. Results: Out of the 248 rural physicians who were successfully mailed the survey in 2007, responses were obtained from 92 for a response rate of 37.1%. In 2012, the response rate was 35.3% (89/252). Descriptive and inferential analyses were conducted in order to monitor and compare technology usage over time in the rural medicine workforce environment. Conclusions: Comparative results across time periods indicated a significant increase in overall technology utilization by rural physicians. In addition, there was a trend of decreasing the disparities in technology utilization between gender, age, and employment groups. Among all groups of physicians in both 2007 and 2012, the highest technology usage was of internet databases, journals and e-publications.
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