Recruitment and Retention of Primary Care Physicians at Community Health Centers: A Survey of Massachusetts Physicians

Abstract

As the backbone of the safety-net system, community health centers (CHCs) provide access to essential services, yet contend with high provider turnover. Using an online survey, primary care physicians (PCPs) at 62 Massachusetts League of Community Health Centers member sites were queried about recruitment and retention factors. Nearly 300 (n=294) PCPs representing 46 CHCs completed the survey. Female physicians, those practicing in the greater Boston area, and those in practice for 10 or more years reported a higher likelihood of remaining in a CHC. Additional factors included: residency preparedness to practice in CHCs; the interview process; and satisfaction with the CHC's mission, patient diversity and current compensation. With the expansion of CHCs, attention must be paid to the PCP workforce. These survey results can inform advocates, leaders, policymakers, and educators regarding workforce initiatives and practice redesign. Once a commitment is made to caring for CHC patients, if this commitment is sustained, retention is good.

Proportion of doctors who stayed in the state of Tocantins after finishing medical residency: preliminary results from a cross-sectional study

“…14 Their findings were corroborated by Savageau et al 12 In Brazil, a previous study identified the following reasons for difficulty in hiring medical specialists, as pointed out by managers of municipal and state public healthcare systems: lack of graduate professionals, according to the criteria of the Ministry of Education and the Brazilian Medical Association; lack of professionals with the experience required for the work; and the fact that professionals consider that the remuneration levels offered by institutions are low. 15 Comparison between these data and the preliminary results from the present study showed that training more doctors does not lead to more specialists working in the public healthcare system.…”

“…9 One important question is how to attract doctors to work in primary care and in rural areas. No exact answers have been presented, but the following have been found to be predictive of continued retention in the face of adversity: revision of medical school curricula to encompass current inpatient-oriented training programs; 10 hiring of doctors with residency in family or community practice; 11,12 working in a greater city area; 12 satisfaction with community health centers; 12 and prior resilience under adverse circumstances. 13 Landry et al 14 observed that medical training at the undergraduate level did not affect the likelihood of ever or currently practicing in a Canadian province.…”

Physicians’ Perceptions of Volunteer Service at Safety-Net Clinics

“…This is a burning issue that has been studied in the context of employed [19][20][21] and volunteer 28,29 physicians. As noted by Clary and Snyder 36 and documented by Ahmed and Maurana 28 and Shuman et al, 29 recruitment and retention should match the functions that volunteering serves for the volunteer population.…”

“…Physicians employed directly by community clinics experience many of the same challenges facing volunteers, leading to similar difficulties in recruitment and retention. [16][17][18][19][20][21] Many studies have focused on how to recruit and retain employed physicians in community clinics. 16,[18][19][20][21] One way is to tailor such programs to the physicians' motivations for working with the underserved.…”

“…Many clinicians working in community clinics are specifically attracted to the missions of such clinics. 16,[18][19][20]22 Curlin et al 23 and Cole et al 18 found that the physicians' faith/ religion was a common motivator for working with underserved populations at community clinics, but that aspects of the physicians' personalities (such as the desire to "make a difference") may be of more fundamental importance. Stevenson et al 24 recorded physicians stating that working in community clinics "was the right thing to do" and a source of significant satisfaction.…”