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New Partner Recruitment to Rural Versus Urban Ob-Gyn Practices : A Survey of Practicing Ob-Gyns

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      The purpose of this pilot study was to investigate the recruitment efforts of practicing obstetrics and gynecology (ob-gyns) from rural and urban practices.


      The authors surveyed practicing ob-gyns from 5 states in the Pacific Northwest in 2016 about their background, practice setting, practice profile, partner recruitment, and retention.


      Seventy-three patients completed the study (53.2% response rate). Thirty-seven percent of respondents work in an urban practice and 43% have a rural practice, with the remainder in a suburban setting. A majority of the respondents attempted to recruit a new partner in the past 5 years. Respondents were most interested in experience and diversity in new recruits. Urban respondents, however, were more interested in hiring those with specialized skills (χ 2 = 7.842, P = .02) than rural providers who were more interested in partners familiar with their community (χ 2= 7.153, P = .03). Reasons most often cited to leave their practice were reimbursement, limited social/marital options, and workload, other than rural providers who more often also cited lack of access to specialty care (χ 2= 13.256, P = .001). Rural providers were more likely to cite marital and family status as an advantage to recruitment, whereas urban and suburban providers were more often neutral.


      Reduced access to care has led to significant health disparities for women living in rural communities. Understanding which providers are most likely to be successful in these settings might help preserve access as our health-care systems evolves.

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      Most cited references 14

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      Health disparities among lesbian, gay, and bisexual older adults: results from a population-based study.

      We investigated health disparities among lesbian, gay, and bisexual (LGB) adults aged 50 years and older. We analyzed data from the 2003-2010 Washington State Behavioral Risk Factor Surveillance System (n = 96 992) on health outcomes, chronic conditions, access to care, behaviors, and screening by gender and sexual orientation with adjusted logistic regressions. LGB older adults had higher risk of disability, poor mental health, smoking, and excessive drinking than did heterosexuals. Lesbians and bisexual women had higher risk of cardiovascular disease and obesity, and gay and bisexual men had higher risk of poor physical health and living alone than did heterosexuals. Lesbians reported a higher rate of excessive drinking than did bisexual women; bisexual men reported a higher rate of diabetes and a lower rate of being tested for HIV than did gay men. Conclusions. Tailored interventions are needed to address the health disparities and unique health needs of LGB older adults. Research across the life course is needed to better understand health disparities by sexual orientation and age, and to assess subgroup differences within these communities.
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        U.S. physician satisfaction: a systematic review.

        There is concern in the US about the burden and potential ramifications of dissatisfaction among physicians. The purpose of this article is to systematically review the literature on US physician satisfaction. A MEDLINE search with the medical subject headings (MeSH) phrases: (physicians OR physician's role OR physician's women) AND (job satisfaction OR career satisfaction OR burnout), limited to humans and abstracts, with 1157 abstracts reviewed. After exclusions by 2 independent reviewers, 97 articles were included. Physician type sampled, sample size/response rate, satisfaction type, and satisfaction results were extracted for each study. Satisfaction trends were extracted from those studies with longitudinal or repeated cross sectional design. Variables associated with satisfaction were extracted from those studies that included multivariate analyses. Physician satisfaction was relatively stable, with small decreases primarily among primary care physicians (PCPs). The major pertinent mediating factors of satisfaction for hospitalists include both physician factors (age and specialty), and job factors (job demands, job control, collegial support, income, and incentives). The majority of factors associated with satisfaction are modifiable. Tangible recommendations for measuring and diminishing dissatisfaction are given.
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          Factors in recruiting and retaining health professionals for rural practice.

          Rural communities, often with complex health care issues, have difficulty creating and sustaining an adequate health professional workforce. To identify factors associated with rural recruitment and retention of graduates from a variety of health professional programs in the southwestern United States. A survey collecting longitudinal data was mailed to graduates from 12 health professional programs in New Mexico. First rural and any rural employment since graduation were outcomes for univariate analyses. Multivariate analysis that controlled for extraneous variables explored factors important to those who took a first rural position, stayed rural, or changed practice locations. Of 1,396 surveys delivered, response rate was 59%. Size of childhood town, rural practicum completion, discipline, and age at graduation were associated with rural practice choice (P < .05). Those who first practiced in rural versus urban areas were more likely to view the following factors as important to their practice decision: community need, financial aid, community size, return to hometown, and rural training program participation (P < .05). Those remaining rural versus moving away were more likely to consider community size and return to hometown as important (P < .05). Having enough work available, income potential, professional opportunity, and serving community health needs were important to all groups. Rural background and preference for smaller sized communities are associated with both recruitment and retention. Loan forgiveness and rural training programs appear to support recruitment. Retention efforts must focus on financial incentives, professional opportunity, and desirability of rural locations.

            Author and article information

            [1 ]Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
            [2 ]The American College of Obstetricians and Gynecologists, Washington, DC, USA
            Author notes
            Michael F. Fialkow, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Box 356460, Seattle, WA 98195, USA. Email: mfialkow@
            Health Serv Res Manag Epidemiol
            Health Serv Res Manag Epidemiol
            Health Services Research and Managerial Epidemiology
            SAGE Publications (Sage CA: Los Angeles, CA )
            19 September 2017
            Jan-Dec 2017
            : 4
            28955717 5607916 10.1177/2333392817723981 10.1177_2333392817723981
            © The Author(s) 2017

            This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (

            Funded by: Maternal and Child Health Bureau, FundRef;
            Award ID: UA6MC19010
            Pilot Study
            Custom metadata
            January-December 2017


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