Abstract
Objectives
As part of a larger case study exploring physician retention factors and strategies employed by rural communities, the objective of this analysis was to explore the community factors that promoted physician retention.
Methods
A qualitative, collective case study design was employed to study four rural communities (cases) in Alberta that retained family physicians for four years or longer. Participants included physicians, staff members, spouses and community members (all were patients from the communities studied). Communities were selected through a retention-specific matrix; each quadrant represented a particular community typology. Case data collected from interviews, documents and observations were analyzed, and similarities and differences among cases were assessed.
Results
A range of community factors that could influence physicians’ decisions to stay in a particular community were described by participants. Four themes, Appreciation, Connection, Active Support and Physical/Recreational Assets, were positively related to physician retention in the four communities studied. These community factors existed to different degrees but were present in all communities. Reciprocity was a fifth factor that emerged in three of the four communities studied.
Conclusion
Physicians, policy-makers, community members and health care professionals are encouraged to consider the community domain when planning and implementing strategies to retain rural physicians and other health care professionals. The four communities studied were able to promote retention of their primary care physicians by showing appreciation to them, building connections with them and their families, actively supporting their physicians and local health facilities, maintaining and improving local physical/recreational amenities, and nurturing reciprocal rapport with physicians.
Keywords: Physician; retention; community; rural health services; case study
Résumé
Objectifs
Dans le cadre d’une vaste étude de cas sur les facteurs et les stratégies de fidélisation des médecins en milieu rural, nous avons voulu analyser les facteurs communautaires qui favorisent le maintien en poste de ces médecins.
Méthode
Nous avons mené une étude qualitative et collective dans quatre communautés rurales de l’Alberta (les « cas ») ayant conservé leurs médecins de famille quatre ans et plus. Les participants étaient des médecins, des membres du personnel, des conjoints et des résidents (tous des patients des communautés à l’étude). Les communautés ont été choisies selon une matrice portant spécifiquement sur la fidélisation; chaque quadrant représentait une typologie communautaire particulière. Nous avons recueilli les données au moyen d’entretiens, de documents et d’observations, analysé ces données, puis évalué les similitudes et les différences entre les cas.
Résultats
Les participants ont cité divers facteurs communautaires ayant pu influencer la décision des médecins de rester dans une communauté donnée. Quatre thèmes (appréciation, relations, soutien actif et équipements physiques/récréatifs) étaient positivement liés à la fidélisation des médecins dans les quatre communautés étudiées. Ces facteurs étaient présents à différents degrés dans toutes les communautés. Un cinquième facteur, la réciprocité, était présent dans trois des quatre communautés.
Conclusion
Nous encourageons les médecins, les stratèges, les résidents et les professionnels de la santé à tenir compte de l’aspect communautaire lorsqu’ils planifient et mettent en œuvre des stratégies pour fidéliser les médecins et autres professionnels de la santé en milieu rural. Les quatre communautés à l’étude ont réussi à fidéliser leurs médecins de premier recours en leur montrant leur appréciation, en tissant des relations avec eux et leurs familles, en appuyant activement leurs médecins et leurs établissements de santé locaux, en entretenant et en améliorant les équipements physiques et récréatifs locaux et en entretenant des rapports de réciprocité avec les médecins.
Motsclés: médecin; fidélisation; communauté; service santé milieu rural; études de cas
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