Factors Influencing Practice Location The More Things ... · PDF file1 The More Things Change,...
Transcript of Factors Influencing Practice Location The More Things ... · PDF file1 The More Things Change,...
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The More Things Change, The More They Stay the Same:Key factors influencing choice of practice locations of family physicians at four different career points
Denis Heng1, Raymond W. Pong1, Miriam McDonald2,
Tom Crichton31 Centre for Rural & Northern Health Research,
Laurentian University2 Northeastern Ontario Medical Education Corporation,
Sudbury ON3 Northeastern Ontario Family Medicine Program,
NOMEC
Northern Health Research Conference – June 3, 2006
Factors Influencing Practice Location
n Rural medical exposure
n Remuneration
n Workload
n Professional support
n Spousal employment opportunities
n Children’s education
n Community characteristics
n Personal characteristics
Welcome to Northern Ontario
n Really bign 89% of Ontario
n Pop: 839,549
n 7.4% of Ontario
n Primary industry sectorn Mining and Forestry
n Public sector employmentn Education and Health care
Northeastern Ontario Family Medicine (NOFM) Program
n Affiliated with the Northern Ontario School of Medicine
n Trains graduates from any Canadian medical school in family medicine
n Community-based, 2-yr residency program
n Northern ON regional programs begun in 1991
Methods
n Years of data: 2001-2005
n Two measures of importance:n Indicate the relative importance of different
factors on influencing choice of practice location
n Indicate the top three factors of importance in influencing the choice of practice location
n 5-point response scale
n Approved by Laurentian University REB
Nineteen Factors of Influence
§ Opportunity for a variety of medical experiences § Adequate on-call coverage§ Availability of hospital facilities / services§ Previous contacts with health care professionals in community§ Access for specialists for consultation§ Previous medical practice in community § Availability of CME opportunities§ Income potential§ Bursaries’ / incentive program’s return-of-service requirements§ Opportunity for career advancement
Professional factors (11)
§ Lifestyle of the community§ Quality of the physical environment in the area§ Cultural and recreational opportunities§ Size / population of community§ Medical needs in community
Community Factors (5)
§ Influence of spouse/partner§ Proximity to family/relatives§ Proximity to friends / colleagues
Personal factors (3)
2
Relative Importance – Entry respondents
3.08
4.14
4.23
4.25
4.27
2.0 2.5 3.0 3.5 4.0 4.5 5.0
Income Potential
Quality of the physical environment
Influence of spouse / partner
Opportunity for a variety of medicalexperiences
Life-style of the community
Relative Importance – Exit respondents
3.05
4.15
4.25
4.32
4.35
2.0 2.5 3.0 3.5 4.0 4.5 5.0
Opportunity for career advancement
Opportunity for a variety of medicalexperiences
Adequate on-call coverage
Influence of spouse / partner
Life-style of the community
Relative Importance –2-Yr respondents
2.83
4.00
4.15
4.24
4.35
2.0 2.5 3.0 3.5 4.0 4.5 5.0
Opportunity for career advancement
Opportunity for a variety of medicalexperiences
Quality of the physical environment in thearea
Influence of spouse / partner
Life-style of the community
Relative Importance – 5-Yr respondents
2.46
3.81
4.02
4.12
4.30
2.0 2.5 3.0 3.5 4.0 4.5 5.0
Opportunity for career advancement
Cultural and recreational opportunities
Opportunity for a variety of medicalexperiences
Life-style of the community
Influence of spouse / partner
Relative Importance
5th3rd6th4thQuality of the physical environment in the area
1st2nd2nd3rdInfluence of spouse / partner
3rd4th4th2ndOpportunity for a variety of medical experience
2nd1st1st1stLife-style of the community
5-Yr2-YrExitEntryRelative Influence
Relative Importance
2
2.5
3
3.5
4
4.5
5
Income potential
Medical needs in com
munity
Influence of spouse / partner
Quality of education for child(ren)
Availability of hospital facilities / services
Previous contacts with healthcare professionals
Adequate on-call coverage
Proximity to extended fam
ily / relatives
Proximity to friends / colleagues
Cultural and recreational opportunities
Opportunity for career advancem
ent
Access for specialists for consultation
Opportunity for a variety of m
edical experiences
Quality of the physical environm
ent in the area
Life-style of the comm
unity
Previous medical practice in com
munity
Size / population of comm
unity
Availability of CME opportunities
Bursaries / incentive program's return-of-service
Ave
rag
e R
atin
g S
core
EntryExit
2-Year
5-Year
3
Rank Order of Importance
4th3rd3rd4thLife-style of the community
2nd2nd2nd3rdProximity to extended family / relatives
3rd4th4th2ndOpportunity for a variety of medical experience
1st1st1st1stInfluence of spouse / partner
5-Yr2-YrExitEntryRank Order of Influence
Some factors influencing practice location remain stable across different career points
n Influence of spouse/partnern Opportunity for a variety of medical experiences
n Proximity to extended family/relativesn Lifestyle of the community
n Opportunity for career advancement
n Availability of CME opportunities
Some factors influencing practice location change between different career points
n Cultural and recreational opportunities
n Previous medical practice in the community
n Adequate on-call coveragen Proximity to friends/colleagues
And sometimes it depends on how you ask the question
n Previous contacts with health care professionals in the community
n Medical needs in the community
n Income potential
n Bursaries’/Incentives program’s return-of-service requirements
n Quality of the physical environment in the area
n Quality of education for children
n Availability of hospital facilities/services
n Access for specialists for consultation,
n Size/population of community
Study Limitations
n Unable to establish causation
n Small sample size of unique group of family medicine graduates
n Generalizability of results
Acknowledgements
n Northeastern Ontario Family Medicine Program
n Monique Lapointeand Linda Liboiron-Grenier
n Past and present CRaNHR colleagues who have worked on this project.