People residing in underserved and low-income communities continue to face a shortage of primary care physicians, increasingly affecting their ability to receive timely and appropriate clinical care. As fewer medical students choose primary care, it is becoming more difficult to recruit and retain physicians in underserved communities.
A community-based participatory research project was conducted in Los Angeles to determine what factors contribute to physicians’ decisions to practice in or leave an underserved area.
Some 42 physicians in some aspect or primary care (48% internal medicine; 31% family medicine; 17% pediatrics) were interviewed with qualitative interviewing techniques.
Several themes emerged in answer to the question “How did you decide to work here?" Physicians who worked in underserved areas were more likely to emphasize personal motivators (mission-based values), while those who practiced in nonunderserved areas emphasized career motivators (work hours and lifestyle) as reasons for choosing practice location. Physicians who trained in a nonunderserved community were unlikely to practice in an underserved setting.
African-American, Latino and White physicians cited the same top-three reasons for choosing a practice location: 1) mission-based values, 2) personal growth, and 3) geography.
Physicians who left an underserved area said they did so because of work hours and lifestyle, practice location, higher salary, career progression and work environment.