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Original Research

Women in rural family medicine: a qualitative exploration of practice attributes that promote physician satisfaction

AUTHORS

Carol Hustedde1 PhD, Assistant Professor *

Heather Paladine2 MD, MEd, Assistant Professor

Andrea Wendling3 MD, Associate Professor

Rupa Prasad4 MD, Anesthesia Resident

Orlando Sola5 MD, Physician

Sarah Bjorkman6 MD, Obstetrics and Gynecology Resident

Julie Phillips7 MD, MPH, Associate Professor

AFFILIATIONS

1 University of Kentucky College of Medicine, Lexington, Kentucky, USA

2 Columbia University College of Physicians and Surgeons, New York, NY, USA

3, 7 Michigan State University College of Human Medicine, East Lansing, MI, USA

4 University of California San Diego School of Medicine, San Diego, CA, USA

5 Family Health Center of Harlem, New York, NY, USA

6 Yale School of Medicine, New Haven, CT, USA

ACCEPTED: 7 August 2017


early abstract:

Introduction: The United States needs more rural physicians. Although women represent half of all US trained medical students, the rural physician workforce has remained predominantly male. Insight is needed into what makes rural practice attractive for women and which practice characteristics allow women physicians to practice successfully in rural areas.
This study's purpose was is to examine aspects of the practice environment that impact women physicians' professional satisfaction and commitment to rural medicine.
Methods: Twenty-five women family physicians practicing in rural areas of the United States were interviewed by phone using a semi-structured format. Transcribed interviews were analyzed using an immersion and crystallization approach. Emergent themes were identified, coded, and discussed until team consensus was attained. Interviews continued until saturation of themes was reached.
Results: Three themes emerged from the data, in relationship to practice and employment attributes that contribute to US women physicians' professional satisfaction and willingness to remain in a rural setting: professional relationships, practice characteristics, and support during times of transition. The study findings describe specific
attributes features of respondents' practice and employment settings that contribute to professional satisfaction and willingness to remain in a rural setting. Participants placed high importance on professional relationships, both within and outside of their rural practice. Rural women physicians
enjoyed practicing an expanded scope of care, feel valued loan repayment opportunities, are beneficial,and appreciated supportive practice partners and value relationships with colleagues. Importantly, women physicians who found themselves struggling to maintain rural careers often had experienced difficulty during times of practice transition, including maternity leaves.
Conclusions: Understanding practice attributes characteristics valued by successful rural women family physicians in the United States will help rural health systems, practices, and physicians-in-training to develop and evaluate opportunities that will best contribute to successful rural practice. Supporting women physicians during periods of practice transition may improve retention.