title: Preliminary evidence on retention rates of primary care physicians in rural and urban areas.
abstract: The primary study objectives were to 1) determine how many physicians entered primary care practice in rural and urban counties of North Carolina in the 1981 to 1989 period and 2) estimate their length of tenure in these areas. The secondary objective was to identify the physician's demographic, training, and practice characteristics that influence geographic location of practice and length of tenure. A cohort of 1,947 physicians was identified from the North Carolina Board of Medical Examiners database, which included all active, nonfederal primary care physicians who began their initial practice in North Carolina in 1981 or later. The primary outcome was time in practice in a given rural or urban county. Selected data on physician demographic, training and practice characteristics were also available in the database. Approximately one third of physicians beginning their initial North Carolina practice selected a rural county for the location. Almost half of these primary care physicians were still in the county of their initial practice in 1989. An additional 20% of these physicians had changed practice location within the State, of which half chose a similar type of county to that of their initial practice. Length of tenure was similar across geographic locations of the medical practice, with the average length of tenure being 4.6 and 4.4 years among physicians in rural and urban counties, respectively. The strongest predictors of tenure were practice organizational characteristics with physicians in either an office-based solo practice or partnership having longer tenures.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Center for Health Services Research in Primary Care, VA Medical Center, Durham, NC.
authors.forename: R D
authors.initials: RD
authors.lastname: Horner
authors.forename: G P
authors.initials: GP
authors.lastname: Samsa
authors.forename: T C
authors.initials: TC
authors.lastname: Ricketts
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D009657:North Carolina; D010821:Physicians, Family / Q000706:statistics & numerical data / Q000600:supply & distribution*; D011320:Primary Health Care; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D013997:Time Factors; D014505:Urban Population / Q000706:statistics & numerical data*