Premium
Dimensions of Retention: A National Study of the Locational Histories of Physician Assistants
Author(s) -
Larson Eric H.,
Hart L. Gay,
Goodwin MaryKatherine,
Geller Jack,
Andrilla Catherine
Publication year - 1999
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/j.1748-0361.1999.tb00762.x
Subject(s) - physician assistants , reimbursement , attrition , family medicine , physician supply , medicine , rural area , nursing , health care , population , nurse practitioners , environmental health , political science , dentistry , pathology , law
This study describes the locational histories of a representative national sample of physician assistants and considers the implications of observed locational behavior for recruitment and retention of physician assistants in rural practice. Through a survey, physician assistants listed all the places they had practiced since completing their physician assistant training, making it possible to classify the career histories of physician assistants as “all rural,”“all urban,”“urban to rural” or “rural to urban.” The study examined the retention of physician assistants in rural practice at several levels: in the first practice, in rural practice overall and in states. Physician assistants who started their careers in rural locations were more likely to leave them during the first four years of practice than urban physician assistants, and female rural physician assistants were slightly more likely to leave than men. Those starting in rural practice had high attrition to urban areas (41 percent); however, a significant proportion of the physician assistants who started in urban practice settings let for rural settings (10 percent). This kept the total proportion of physician assistants in rural practice at a steady 20 percent. While 22 percent of the earliest graduates of physician assistant training programs have had exclusively rural careers, only 9 percent of physician assistants with four to seven years of experience have worked exclusively in rural settings. At the state level, generalist physician assistants were significantly more likely to leave states with practice environments unfavorable to physician assistant practice in terms of prescriptive authority, reimbursement and insurance .