Why rural residents migrate for family physician care

Several studies have examined why rural residents bypass local hospitals, b ut few have explored why they migrate for physician care. In this study, da ta from a random mail survey of households in rural Iowa counties were used to determine how consumers' attitudes about their local health system, hea lth beliefs, health insurance coverage and other personal characteristics i nfluenced their selection of local vs, nonlocal family physicians (family p hysician refers to the family practice, internal medicine or other medical specialist providing an individual's primary care). Migration for family ph ysician cave was positively associated with a perceived shortage of local f amily physicians and use of nonlocal specialty physician care. Migration wa s negatively associated with a highly positive rating of the overall local health care system, living in town, Lutheran religious affiliation and priv ate health insurance coverage. By understanding why rural residents prefer to bypass local physicians, rural health system managers, physicians and po licy-makers should be better prepared to design innovative health organizat ions and programs that meet the needs of rural consumers.