Gender differences in rural and urban practice location among mid-level health care providers.
BACKGROUND
Mid-level providers comprise an increasing proportion of the health care workforce and play a key role in providing health services in rural and underserved areas. Although women comprise the majority of mid-level providers, they are less likely to work in a rural area than men. Maldistribution of health providers between urban and rural practices is an important issue influencing health care.


OBJECTIVE
To gain further insight into this issue, this study examined how mid-level practice location varied by gender.


METHODS
Semistructured interviews were conducted with a purposive sample of 55 nurse practitioners, physician assistants, and nurse anesthetists in New York State and Pennsylvania.


RESULTS
Results suggest that family and community ties played a key role in influencing practice location. Men were particularly drawn to the broad scope of practice and autonomous nature of rural practice. Women in rural areas enjoyed the more personable environment and greater respect from colleagues and patients. Both male and female rural providers preferred their location because there were fewer turf issues, while some women were concerned about being professionally isolated. Meanwhile, both men and women enjoyed the fast pace, specialization, and greater opportunities urban areas had to offer.


CONCLUSIONS
Recruitment efforts should focus on candidates from rural areas and not underestimate the impact of family in decisions about work location.
Lindsay
Sally
S
Institute for Social, Cultural & Policy Research, University of Salford, United Kingdom. s.lindsay@salford.ac.uk
D000328:Adult; D001291:Attitude of Health Personnel; D002321:Career Choice; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009518:New York; D009719:Nurse Anesthetists / Q000523:psychology / Q000600:supply & distribution; D009722:Nurse Practitioners / Q000523:psychology / Q000600:supply & distribution; D010414:Pennsylvania; D010823:Physician Assistants / Q000523:psychology / Q000600:supply & distribution; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D019035:Rural Health Services; D012737:Sex Factors; D011795:Surveys and Questionnaires; D019037:Urban Health Services; D000078329:Workforce