Influence of hometown on family physicians' choice to practice in rural settings.
OBJECTIVE
This study examines the influence of a physician's hometown location on the choice of practice location, adjusting for confounding variables.


METHODS
Medical school records for 2,487 Indiana University graduates (classes of 1988--1997) were matched to the American Medical Association's Masterfile data to identify the graduates' current practice locations and specialties. Urban influence codes were assigned to each county in Indiana for the purposes of defining metro or nonmetro locations. Physician practice locations were mapped using ArcGIS software. Chi-square tests, logistic regression, and analysis of variance were used to examine the influence of hometown on choice of practice location.


RESULTS
Chi-square tests revealed significant associations between physician hometown and current practice location. Logistic regression, controlling for age and gender, predicted physicians (all specialties) from nonmetro hometowns were 4.7 times as likely to locate their practice in a nonmetro location as compared to their peers from metro hometowns. Similarly, family physicians from nonmetro hometowns were 4.4 times as likely to choose a nonmetro practice location. There was not a significant difference in the mean distance between hometown and practice location for physicians from nonmetro hometowns compared to those from metro hometowns.


CONCLUSIONS
This study underscores the influence of physicians' hometown on their choice of practice location.
Wade
Michael E
ME
Indiana State Department of Health, USA.
Brokaw
James J
JJ
Zollinger
Terrell W
TW
Wilson
Jeffrey S
JS
Springer
James R
JR
Deal
Dennis W
DW
White
Gary W
GW
Barclay
Jonathan C
JC
Holloway
Angela M
AM
D002755:Choice Behavior; D019992:Databases as Topic; D005260:Female; D006801:Humans; D007196:Indiana; D016015:Logistic Models; D008297:Male; D010821:Physicians, Family / Q000706:statistics & numerical data*; D011365:Professional Practice Location; D012111:Residence Characteristics; D012424:Rural Population