Physician Recruitment Research Articles

Training for rural family medicine: a cooperative venture of government, university, and community in Alberta.

Training, recruiting, and retaining family physicians in rural areas are issues that have attracted the attention of governments, university training programs, medical governing bodies, and rural communities. In this article, the authors describe a cooperative venture between government, university, and community in the province of Alberta to train medical students and residents in rural areas. The Rural Physician Action Plan (RPAP) was developed in the early 1990s to improve the recruitment and retention of physicians in rural areas. The RPAP is coordinated by a committee composed of representatives of the Alberta government, the Alberta Medical Association, the College of Physicians and Surgeons of Alberta, and the faculties of Medicine at the University of Alberta and the University of Calgary. Residents in the University of Alberta Department of Family Medicine are required to do 20 weeks of blocktime training in a community practice, and under the auspices of the RPAP rural training sites were identified and rural rotations developed. Faculty development activities were developed for the community physicians who would host the residents. The RPAP funds 24 third-year residency positions, equally divided between the University of Calgary and the University of Alberta. Beginning in 1994, undergraduate medical students at the University of Alberta were required to complete a four-week family medicine rotation, with a majority of students being posted to rural training sites. The extent to which the RPAP has helped to recruit and retain physicians in rural areas is not clear. The provincial Ministry of Health evaluated the RPAP in 1995 and concluded that, at a minimum, without the RPAP the province would have suffered a net loss of rural physicians. The communities have been very accepting and supportive of the students and residents.

Differences in the professional satisfaction of general internists in academically affiliated practices in the greater-Boston area. Ambulatory Medicine Quality Improvement Project Investigators.

Managed care has created more professional constraints for general internists. We surveyed 198 general internists at 12 academically affiliated practices in the greater-Boston area to examine professional satisfaction. Overall, these physicians were moderately satisfied (mean of 59.1 on a 100-point scale). Before adjustment, women had lower overall satisfaction than men, as well as poorer satisfaction with the domains of career concerns and patient access. Gender had no independent effect on satisfaction after adjustment for age, income, percentage of time providing direct patient care, work status, and site. Younger physicians also had lower overall satisfaction, and these differences remained after adjustment. Improvements in professional satisfaction may be required to ensure the continued recruitment of young physicians, particularly women, into general internal medicine.

Technology acquisition decision making revisited: lessons learned in an age of environmental uncertainty

High technology medical innovation remains implicated as one of the most significant driving forces behind the high costs of health care in the USA. In addition, health care organisations are faced with an increasingly complex and uncertain environment. How do these factors interrelate to affect decisions made to acquire high cost medical technology? Data was collected from hospitals in three states attempting to assess how environmental variables affect technology acquisition decision making. Among the important criteria are physician recruitment and retention and perceived competitive pressure. An analysis of the data reveals that technology is acquired as one means of reducing environmental uncertainty. Within a growing number of integrated health systems, collaboration acts to both control costs and reduce duplicative technology. In order for collaboration to be successful, a strong bond of trust must exist between decision makers in addition to any economic benefit derived from the union.

Attracting Physicians to Underserved Communities Is Not the Solution to Providing Better Access to Underserved Communities

Thomas P. Weil's Attracting Physicians to Underserved Communities: The Role of Health Networks suffers from a lack of focus, a lack of definition of the problems and participants, and a lack of documentation to support either the author's premises or conclusions. Unfortunately, Weil falls victim to the age-old phobia of trying to draw attention to a specific problem by describing anything and everything as either a causative agent or a confounding variable. The result is an accumulation of some related and some unrelated issues that are, at best, confusing. More distressing than the confusing lack of focus is the author's repeated use of inaccurate, inappropriate, and worn-out categorizations. The reader is left wondering whether the author is truly interested in the recruitment of physicians to underserved communities or simply flailing away at the suspected sociopolitical causes of poverty in America. For example, the world that I live in is not simply divided into urban and communities and poor rural and inner-city communities. In fact, people who live in the inner city face different problems of access to medical care than those who live in rural settings. The same can be said for people who live in urban versus environments, regardless of their economic status. Another problem with Weil's thesis is that if Weil can actually accumulate 73 million... and underinsured Americans, I doubt seriously that either Weil, or those he quotes, really expect us to believe that: (1) all of these people cannot obtain any form of basic health coverage; (2) all 73 million of these people live in poor rural and inner-city environments; (3) the lack of health coverage for this group is caused by a geographic maldistribution of physicians in America; and (4) the health coverage of this group will be enhanced by recruiting physicians and somehow paying the physicians 30 percent more than average, providing a collegial work environment, or both. Descriptors such as affluent and poor, suburban and inner city separate, segregate, and categorize human beings in negative ways, without defining the maldistribution problem. The way Weil uses these terms in an attempt to define his thesis implies that physicians and other institutional healthcare providers are somehow guilty of causing the problems that underinsured people experience, simply by where physicians practice medicine or where hospitals were constructed 20 to 50 years ago. Weil focuses on several approaches that health networks might use to increase their market penetration. Health networks is an amorphous term that has no real definition, and I am unaware of any health executive who believes that capturing the uninsured to increase market share is a viable concept for health networks. However, I wonder why health networks are mentioned to the exclusion of local and state public health departments; local, county, state and federal government programs; and social service agencies that deal with the elderly, children, unwed mothers, substance abuses, and so forth. Most Americans cannot identify a health network because most Americans are provided health services by private, public, and governmental agencies and providers that are not part of a health network. Health network is the current buzzword, but it is certainly not descriptive of the organizations and people who provide health services to the American people. Weil offered specific recommendations for health networks that attempt to solve the maldistribution crisis. Each recommendation is enumerated below, followed by my interpretation. According to Weil, health networks should: 1. Provide eminent leadership in the overall design and governance of soundly conceived Medicaid HMOs. …

Tacrine hydrochloride treatment IND: methods for rapid physician and patient enrollment and data retrieval.

A Treatment IND (TIND) is a mechanism available to the Food and Drug Administration (FDA) in the United States by which promising new drugs can be provided to patients with life-threatening illnesses. In many instances, the illness is life-threatening but of relatively low incidence, making the demand for the new treatment limited. However, if the disease is more prevalent and incidence is increasing, the demand for access to an experimental therapy may be substantially greater. Novel approaches and technologies would help manage recruitment of physicians, enrollment of patients and retrieval and timely analysis of data. Such was the case in the TIND for tacrine hydrochloride (Cognex), a cholinesterase inhibitor which was under development for the treatment of patients with Alzheimer's Disease (AD). There were an estimated 4 million prevalent cases of AD in the US for which no approved therapeutic option was available at the time this TIND was initiated. We anticipated that there could be a large demand by both physicians and patients to enroll in the TIND. Therefore, to meet this demand, various mechanisms were employed to allow rapid enrollment and drug shipments to the patient. In addition, physicians who participated in the TIND were able to use a telephone touch-tone data entry system for reporting data and ordering new supplies of tacrine for their patients. Serious adverse events were reported directly to trained operators and summarized on a weekly basis for reporting to the FDA. At the time the programme was terminated, nearly 2000 physicians had enrolled to participate in the TIND and nearly 10,000 patients had received tacrine under the programme. The methods employed in this study to collect clinic visit and safety data met both regulatory and good clinical practice guidelines. In summary, a large volume of data was handled rapidly and efficiently in this programme.

Recruitment of Primary Healthcare Physicians in Rural Areas

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsC. William RoeAnne Perch intends to work in healthcare administration. RamMohan R. Yallapragada is an associate professor in the Department of Accounting Betty Birkenmeier is a graduate student and research assistant in the Department of Management; Joel P. Authement is the Celeron Professor of Management; and C. William Roe is the associate dean and MBA director, all at the University of Southwestern Louisiana.

Physician Recruitment

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Creating a home page on the world wide web: An inexpensive means to promote medical education and physician recruitment

The World Wide Web (WWW) is generally used as an information resource. It can also be used as a national and international promotional (advertising) resource, at minimal cost, to assist in physician recruitment, such as for residency training programs. Currently, only a few residency training programs have home page sites describing their programs on the WWW. Creating a WWW site that can be viewed nationally and internationally requires an internet service provider and hypertext markup language (HTML) document that designs the WWW home page site. This article provides a step-by-step method for creating a simple WWW site (including an HTML template) to promote a residency program and assist in resident recruitment. As more young physicians graduate with more extensive computer skills and familiarity, use of the WWW for physician recruitment will become a more important source of information for physician applicants.

Physician Recruitment

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Physician Recruitment

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