title: Recruiting and retaining physicians in very rural areas.
abstract: BACKGROUND
  Recruiting and retaining physicians is a challenge in rural areas. Growing up in a rural area and completing medical training in a rural area have been shown to predict decisions to practice in rural areas. Little is known, though, about factors that contribute to physicians' decisions to locate in very sparsely populated areas.
  
  
  OBJECTIVE
  In this study, we investigated whether variables associated with rural background and training predicted physicians' decisions to practice in very rural areas. We also examined reasons given for plans to leave the study state.
  
  
  METHODS
  Physicians in the State of Wyoming (N = 693) completed a questionnaire assessing their background, current practice, and future practice plans.
  
  
  RESULTS
  Being raised in a rural area and training in nearby states predicted practicing in very rural areas. High malpractice insurance rates predicted planning to move one's practice out of state rather than within state.
  
  
  CONCLUSIONS
  Rural backgrounds and training independently predict practice location decisions, but high malpractice rates are the most crucial factor in future plans to leave the state.
authors.affiliation: Department of Psychology, University of Wyoming, Laramie, Wyoming 82071, USA. cpepper@uwyo.edu
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Pepper
authors.forename: Ryan H
authors.initials: RH
authors.lastname: Sandefer
authors.forename: Matt J
authors.initials: MJ
authors.lastname: Gray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010558:Personnel Loyalty; D010560:Personnel Selection; D010820:Physicians / Q000600:supply & distribution*; D012424:Rural Population; D011795:Surveys and Questionnaires; D014959:Wyoming