Predictive accuracy of rural physicians' stated retention plans.

Full Abstract

CONTEXT:
The retention of rural physicians is a difficult phenomenon to study because job changes--the outcome of interest--take years to unfold. One common way to study retention is to ask rural practitioners through surveys how much longer they expect to remain in their current positions and use these statements of "anticipated retention" as an expedient proxy measure of actual retention.

PURPOSE:
To test the predictive accuracy of rural physicians' stated retention plans and test the hypotheses that predictions are more accurate for certain physicians, such as those with more experience, more control of their work situations, and at less risk for job burnout.

METHODS:
A 1991 mail survey (national stratified random sample) prospectively queried rural physicians' retention plans, and a follow-up survey 5 to 6 years later determined if and when respondents (N = 405, 67.5% combined response rate) had moved.

FINDINGS:
Retention predictions for the entire cohort corresponded remarkably well to the group's actual retention, with the proportion remaining each year deviating by only a few percentage points from what the group collectively expected. Predictions for individuals were also moderately accurate:
4 of 5 physicians who predicted remaining at least 5 years did so; 2 of 3 who predicted remaining less than 5 years indeed left before 5 years. Predictions of job changes in less than 2 years tended to be more accurate than predictions of 2 to 5 years. Physicians' predictions were more accurate when they worked in practices they owned (greater control) and were on-call 2 or fewer times each week (lower burnout risk). Accuracy was not greater with any of 5 measures of experience.

CONCLUSIONS:
Rural generalist physicians are moderately accurate when reporting how much longer they will remain in their jobs, validating the use of anticipated retention in rural health workforce studies.

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Author information

Author/s: Pathman, Donald E (DE); Konrad, Thomas R (TR); Agnew, Christopher R (CR);

Affiliation: Cecil G. Sheps Center, Chapel Hill, NC 27599, USA. don_pathman(-atsign-)unc.edu

Grants: R01-HS06544 (Agency:AHRQ HHS) ; R03-HS10654 (Agency:AHRQ HHS) ; U76 MB 00005 (Agency:BHP HRSA HHS)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.

Journal: The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association (J Rural Health), published in United States. (Language: eng)

Reference: 2003-; vol 19 (issue 3) : pp 236-44

Dates: Created 2003/07/03; Completed 2003/07/31; Revised 2007/11/14;

PMID: 12839131, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Male
Medically Underserved Area
Personnel Loyalty
Physicians, Family - psychology; supply & distribution
Professional Practice Location
Rural Health Services - manpower
Time
United States

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