TABLE 2 : Types and Influence of Financial Considerations Received on the Decision to Practice Medicine in West Virginia Received FC
FC Influenced Site Selection n % n % Employer Contribution 52 12.0 % 36 69.2 % Military Program ( s ) 28 6.4 % 9 32.1 % National Institutes of Health Research 4 0.9 % 3 75.0 % National Programs ( i . e . National Health Service Corp ) 18 4.1 % 11 61.1 % Non-profit / Private Program 8 1.8 % 6 75.0 % Public Service Loan Forgiveness 18 4.1 % 13 72.2 % Sign-On Bonus 100 23.0 % 48 48 % State Program * 32 7.4 % 17 53.1 % 501 ( c )( 3 ) Employment 17 3.9 % 8 47.1 % Other Loan Forgiveness or Repayment 11 2.5 % 7 63.6 %
TOTALS 288 66.2 % 158 54.9 %
* West Virginia Higher Education Policy Commission Health Sciences Service Program , West Virginia State Loan Repayment Program , West Virginia Recruitment and Retention Community Project Program
payment programs on the choice to practice medicine in WV by practice type of primary care or specialty care .
All respondents were asked whether they received specific financial considerations and whether those financial considerations influenced their choice of practice site ( Table 2 ). More than 65 % of respondents reported receiving at least some type of financial consideration while choosing a practice site with approximately 55 % of those indicating that the financial consideration received influenced their decision to choose that practice . National Institute of Health ( NIH ) Research , nonprofit / private program , and employer contribution support were the most influential types of financial considerations based on percent totals . Sign-on bonuses were examined separately from other employer contributions ( Table 2 ).
Respondents indicated which of the following factors influenced their selection of practice site in WV , selecting all that applied : financial considerations ( n = 111 ), quality of life ( n = 197 ), community attributes ( n = 152 ), and work environment ( n = 181 ). Table 3 shows the number of respondents and ratings of the importance of specific considerations for practice site selection in WV . Cost of living and earning potential were rated highest by respondents in the category of financial considerations . Leisure time and workload were most important to respondents related to quality of life . Ability to make an impact through their practice was the highest ranked community attribute that influenced the selection of practice site of respondents . Finally , work autonomy was the most important attribute of the work environment ranked by respondents that influenced their selection of a practice site .
Identity as a Native of West Virginia
Individuals who identified as a native of WV were more likely to indicate that community attributes , specifically the desire to return to home community , desire to return to a community similar to home community , and desire to return to an established network of family and friends , influenced their decision to practice in the state . Figure 2 illustrates the importance of specific community attributes on the decision to practice medicine in WV as a function of self-identifying as a native of the state .
Figure 2 illustrates the importance of the desire to return to a community similar to home community and importance of having an established network of family and friends on choice of practice location as a function of whether the respondent identified as a native of WV . Number of responses to each Likert-scale option for each group are provided within the embedded table .
Qualitative Analyses of Retention-Focused Questions
Three hundred sixty-three out of 428 participants responded to the question , “ What influenced your selection of practice site in WV ?” Physician responses fell into five major themes : home and family , an opportunity to dually serve as faculty and clinician , to serve where most needed , to pay back debt , and quality of life . Most physicians who responded to this question noted that WV was home , close to their family or their spouses ’ family , and that being close to family was important to them . Many also indicated that there were professional opportunities for their spouse . An opportunity to serve as a faculty and clinician with the support of an academic environment was also extremely important to many respondents . The ability to teach medical students and residents , serve on a medical school faculty , practice clinical medicine , and conduct research were all essential factors in their decision to practice in WV . To be supported by an academic center while practicing in a rural location was also noted by some as influential to their decision . For example , one respondent stated , “ Practice
West Virginia Medical Journal • March 2022 • 35