title: Physician wellness in rural America: a review.
abstract: OBJECTIVE
  The primary purpose of this article is to review the unique wellness factors that affect physicians practicing in rural communities. Research has indicated that rural communities often struggle to attract and retain primary care physicians and numerous wellness factors impact these attraction/ retention rates.
  
  
  METHODS
  Articles selected for inclusion in this review were determined based upon their relevance to rural physicians, overall wellness factors of physicians, and recruitment and retention of physicians in rural communities. Articles were included from peer-reviewed journals focusing upon both medical and psychological perspectives of rural physician wellness factors.
  
  
  RESULTS
  Results indicated that rural physicians often have fewer resources, an increased workload, and longer hours when compared to their urban counterparts. These factors contribute to lower job satisfaction, poor retention rates, and decreased physician wellness. Research also demonstrates that physicians who are unwell are more likely to experience substance abuse, depression, relationship difficulties, and general psychological distress. These issues are particularly prominent in rural practice settings and may have significant impact upon rural patients.
  
  
  CONCLUSIONS
  To date, there are few assessment measures available to assess physician wellness and no evidence-based treatments to address wellness deficits in rural physicians' medical or psychological health. Such resources would have the potential to benefit individual rural physicians and the quality of healthcare they deliver to rural communities. Future research should focus upon the assessment and promotion of rural physician well being, which may improve recruitment and retention of quality physicians to provide optimal care in rural communities.
authors.forename: Treah S
authors.initials: TS
authors.lastname: Haggerty
authors.forename: Scott A
authors.initials: SA
authors.lastname: Fields
authors.forename: Emily M
authors.initials: EM
authors.lastname: Selby-Nelson
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Foley
authors.forename: Carl D
authors.initials: CD
authors.lastname: Shrader
mesh_terms: D006801:Humans; D007588:Job Satisfaction; D010559:Personnel Management / Q000379:methods*; D058007:Physicians, Primary Care / Q000523:psychology*; D011365:Professional Practice Location; D018570:Risk Assessment; D019035:Rural Health Services / Q000458:organization & administration*; D013315:Stress, Psychological / Q000209:etiology