Financial incentive programs were indicated by respondents as effective physician recruitment tools in WV . More than half of respondents received some type of financial consideration that influenced their decision to choose that practice . Employer contributions were the most commonly selected ; NIH research , nonprofit / private program , and employer contribution support were also indicated as highly influential types of financial considerations . Payback for a debt owed emerged as a financial consideration within qualitative data , including visa opportunities and payback for both respondents and / or their spouses in exchange for federal or state financial support of their education . Support from academic medical centers , especially for rural physicians , including the ability to serve as medical school faculty in both teaching and research capacities , were cited as highly influential reasons to stay in practice in WV .
Responses from participants indicated that retention of respondents was strongly influenced by the socioeconomic climate and reimbursement policy in the state , clinical leadership at the local level , and lifestyle factors in the geographic region . Respondents cited the need to improve reimbursement structure and reduce dependence on lower compensating public payors . Respondents also expressed distress over the drug crisis in the state , citing issues with access to care for their patients who are experiencing addiction , as well as the impact addiction has had on their practice patterns and communities . The growing litigious culture was also indicated as a challenge to staying in a WV practice , an issue discussed by Mello and colleagues . 23 Strong local level clinical leadership , including support for practice , teaching , and research , heavily influenced respondents ’ decisions to stay at their practice . Changes in support or leadership were cited as reasons to consider leaving WV .
A limitation of the study is that it is unknown if the participant group is a representative sample of WV physicians . The only publicly available data identified by the authors that provided WV physician demographics provides information on gender , age , specialty , and medical school attended and suggests the study sample is representative of the target population ; however , these data are from the year 2000 . 24
CONCLUSION
Results from the current study indicate that several financial incentives provided through national , state , and employer programs have been used as recruitment tools by practices in WV . Respondents cited loan forgiveness options and employer contributions as influential incentives in practice site selection , in addition to earning potential and cost of living considerations . The ability to make an impact through practice , as well as workload and autonomy , were also highly influential to respondents . Enhancing relationships , recruitment , and coordination of financial incentive programs among higher education , medical schools , residency programs , and community-based practices can help to match physicians to WV practices that address the socioeconomic and personal considerations most likely to secure and sustain employment .
REFERENCES
1 . MacDowell M , Glasser M , Fitts M , Nielsen K , Hunsaker M . A national view of rural health workforce issues in the USA . Rural Remote Health . 2010 ; 10 ( 3 ): 1531 . Doi : 10.22605 / rrh1531 .
2 . Cohn KH , Harlow DC . Field-tested strategies for physician recruitment and contracting . J Healthc Manag . 2009 May-Jun ; 54 ( 3 ): 151-8 . PMID : 19554795 .
3 . Cecil G . Sharps Center for Health Services Research at the University of North Carolina at Chapel Hill . Rural Health Snapshot 2017 . Cecil G . Sheps Center for Health Services Research Web Site . https :// www . shepscenter . unc . edu / product / rural-health-snapshot-2017 /. Accessed December 30 , 2020 .
4 . Association of American Medical Colleges . Physician supply and demand – a 15-year outlook : Key findings . Association of American Medical
Colleges Web Site . https :// www . aamc . org / system / files / 2019-08 / physiciansupply-demand-15-year-outlook-keyfindings . pdf . Accessed June 15 , 2020 .
5 . United Health Foundation . America ’ s Health Rankings Annual Report - 2020 . United Health Foundation America ’ s Health Rankings Web Site . https :// www . americashealthrankings . org / learn / reports / 2020-annual-report . Accessed December 30 , 2020 .
6 . Cecil G . Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill . Rural hospitals have higher percentages of patients with COVID-19 than urban hospitals ( October-December 2020 ). Cecil G . Sheps Center for Health Services Research Web Site . https :// www . shepscenter . unc . edu / product / rural-hospitalizations-for-covid-19- a-snapshot-for-december10-2020 /. Accessed December 30 , 2020 .
7 . Eidson-Ton WS , Rainwater J , Hilty D , et al . Training medical students for rural , underserved areas : A rural medical education program in California . J Health Care Poor Underserved . 2016 ; 27 ( 4 ): 1674-1688 . Doi : 10.1353 / hpu . 2016.0155
8 . Parlier AB , Galvin SL , Thach S , Kruidenier D , Fagan EB . The Road to Rural Primary Care : A Narrative Review of Factors That Help Develop , Recruit , and Retain Rural Primary Care Physicians . Acad Med . 2018 ; 93 ( 1 ): 130-140 . Doi : 10.1097 / ACM . 0000000000001839
9 . Vestal AL , Boone L , Walker R , Sheppard AB , Morris D , Noland AJ . Perceptions of Specialties and Primary Care Careers : Findings from West Virginia Medical Student and Resident Focus Groups . Marshall J Med . 2018 ; 4 ( 4 ). Doi : 10.18590 / mjm . 2018 . vol4 . iss4.10
10 . Shannon CK , Jackson J . Validity of Medical Student Questionnaire Data
38 • www . wvsma . org