Improving Primary Care Retention in Medically Underserved Areas

Abstract

To reduce health professional shortage areas, the National Health Service Corps has attempted to increase the number of primary care providers in underserved communities through scholarships and loan repayment. Program evaluations assessed Loan Repayment Program (LRP) propensity to work in underserved communities. The National Health Service Corps LRPs were asked about preferences for particular retention strategies and which strategies were utilized by their clinical sites. Loan Repayment Programs were asked to rank retention strategies. Loan Repayment Program top choices were competitive salary, 88%; professional development, 70%; knowledgeable/competent support staff, 59%, and professional support, 58%. Loan Repayment Programs were also asked to rank retention strategies provided by their clinical sites: professional development, 74.2%; competitive salary, 71.2%; policies that prohibit abusive behavior, 63.6%, and knowledgeable/competent support staff, 60.6%. Loan Repayment Programs indicated professional support was an important retention element. However, when asked if professional support opportunities were offered, LRP indicated that these were not in the strategies offered by sites.

2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015–2030

“…Expanding financial incentives with service requirements may increase access to care in rural and underserved communities . Surveys suggest that competitive salaries, professional development, knowledgeable support staff, and professional support increase the likelihood of provider retention in rural or underserved areas after completion of service commitments .…”

Addressing inequalities in medical workforce distribution: evidence from a quasi-experimental study in Brazil

“…The recent political changes in Brazil demanded a rearrangement of the programme logic. The MDP, as similar programme in other countries (Mission Barrio Adentro in Venezuela,36 National Health Services Loan Repayment Programme in the USA,37 and Overseas Trained Doctors in Australia38) represents a short-term solution to address the problem of scarcity and inequality in the distribution of the primary care physicians. However, in the long-term, the governments need to solve the inherent problems related to the access to primary healthcare with more comprehensive national policies.…”

2015 American College of Rheumatology Workforce Study and Demand Projections of Pediatric Rheumatology Workforce, 2015–2030

“…Financial incentive programs, including medical student loan debt relief are also important. Loan repayment programs have been employed to increase primary care providers in underserved areas (37). A similar loan repayment program for pediatric rheumatology has been introduced to the US Senate but to date has not moved (38).…”