TABLE 2.

Themes and Subthemes With Sample Quotations Showing Range of Participant Endorsement: Los Angeles County, CA, 2008

Domains	Strong Endorsement	Weaker Endorsement
Personal growth	“At the time, it offered me the combination that I was looking for in a medical practice and teaching opportunity combined.” (underserved, White, family physician)	“Just to practice medicine and take care of patients and make people better.” (underserved, African American, family physician)
Self-identity	“I grew up in the East Los Angeles community … I grew up uninsured … so that was a big motivation to come back and practice in the community here.” (underserved, Latino, family physician)	“I was always irritated … that people [said] because you're not White, that's where you should work.” (nonunderserved, Latino, internist)
Mission-based values	“I feel like I have a moral obligation to be here.” (underserved, White, pediatrician)	“You know, I got to tell you, I guess there's a bit of guilt I feel about not being able to do more in the underserved community, but I do feel we all have to balance that out.” (nonunderserved, Latino, internist)
Salary and benefits	“It was more money; I was also looking for more money and so this current job paid more money.” (underserved, African American, family physician)	“In fact, I didn't even know what my starting salary was. It didn't matter.” (underserved, Latino, family physician)
Work hours and lifestyle	“It also had better hours; I don't have to work weekends anymore, which I did for almost 15 years, so that was an excellent benefit.” (underserved, African American, family physician)	“When we started, we were probably working about, I would say, 70 hours a week. So, it was like being residents again.” (underserved, Latino, family physician)
Career satisfaction	“I love my job. I love coming here. The other thing that's very amenable here is that I'm able to do 10-hour days. I don't come here every day.” (nonunderserved, White, internist)	“People may leave for that. I think people usually leave because they burn out. They burn out, or they can't change the system, and it's just time to move on, or they want to do something different.” (nonunderserved, White, internist)
Family	“I would have left Los Angeles a long time ago if it wasn't for my parents. My parents’ health needs, they need help.” (nonunderserved, African American, internist)	“I also didn't have a family; I was single. I didn't have children, so I didn't have anybody depending on my income, so I could basically do whatever it was that my heart told me.” (nonunderserved, White, family physician)
Geography	“No, I'm from California so I wasn't moving or leaving… . I mean, it did mean a longer drive … but I was used to that.” (underserved, Latino, family physician)	“Probably the only downside of my job is the commute, it's a little bit further than I'd like with the gas prices, but other than that, I'm pretty happy.” (nonunderserved, African American, family physician)
Loan repayment programs	“I was involved in a loan repayment program to work at the community health center.” (underserved, African American, family physician)	“They didn't have any loan repayment for this job. That was called, me—pay it with your own check.” (nonunderserved, African American, internist)
Work environment	“Respect, a positive work environment—and that includes the physical facility … one needs to make it as soothing, as comforting and as warm and friendly as possible.” (nonunderserved, White, pediatrician)	“I'm currently doing very similar things to what I was doing when the hospital was opened, but … I'm doing it in trailers that used to be personnel trailers … so I've been working in this facility for a while.” (underserved, White, pediatrician)
Provider team	“There's also tons of receptionists, there's tons of education coordinators, there's a disability coordinator … so the physician is just kind of guiding the care and to me, that has been a fantastic model.” (nonunderserved, African American, family physician)	“We're not overly staffed. We can't afford it … we kind of just get by with and do whatever we have to do.” (underserved, Latino, family physician)
Reimbursement	“In the county system, I had to really see what was the bare minimum I could do for the patients to actually get them to be somewhere in a positive state of health. Here, I have more options because they have coverage… . I have less obstacles in care.” (nonunderserved, Latino, family physician)	“I always know how good I have it because I don't have to worry about a person having a plastic card … I know I have to sometimes really advocate/fight for resources for my patients, but at least they can get in the door, and these people are the most in need.” (underserved, Latino, family physician)
Information support	“We have a fantastic electronic record where someone's labs can be forwarded to me easily and I don't need to pull a chart … so I don't necessarily need to be in the office to do those things.” (nonunderserved, African American, family physician)	“ … with the implementation of our electronic medical record … but it also is a lot slower than the old paper records … I think it is eating into a lot of personal time and causes stress and has caused some people to leave.” (nonunderserved, White, family physician)

Note. Themes and subthemes were developed from respondents’ answers to study protocol questions, including “How did you decide to work here?” and questions asked for 3 scenarios: before you worked here, while you worked here, and whether you stayed or considered leaving, including “What was your motivation for working here at this location? What are your career expectations and how have they changed? What are the support mechanisms here? How has your family influenced your decisions? How does your background influence your decisions? How does your patient population affect your decision to work here? What advice and recommendations do you have for recruiting more doctors to underserved areas?”