Demographic, educational and economic factors related to recruitment and retention of physicians in rural Pennsylvania

While prior studies have identified a number of factors individually relate d to physician practice in rural areas, little information is available reg arding the relative importance of these factors or their relationship to ru ral retention. Extensive data previously collected from the Jefferson Longi tudinal Study were analyzed for 1972 to 1991 graduates of Jefferson Medical College practicing in Pennsylvania in 1996, as were recent self-reported p erceptions of Jefferson Medical College graduates in rural practice. Rural background was overwhelmingly the most important independent predictor of r ural practice, and freshman plans to enter family practice was the only oth er independent predictor. No other variable, including curriculum or debt, added significantly to the likelihood of rural practice. None of these vari ables, however, including rural background, was predictive of retention, wh ich appeared to be more related to practice issues such as income and workl oad. These results suggest that increasing the number of physicians who gre w up in rural areas is not only the most effective way to increase the numb er of rural physicians, but any policy that does not include this may be un successful.