Economist Vick Publishes on Rural/Urban Differences in Physician Satisfaction and Career Plans

Posted on 9/8/2015 8:27:13 AM

Economics professor Brandon Vick published a study titled “Analyzing Rural Versus Urban Differences in Career Dissatisfaction and Plans to Leave Among Pennsylvanian Physicians” in a forthcoming issue of the Journal of Rural Health.

This study estimates whether physicians in rural Pennsylvania have higher odds of career dissatisfaction and plans to leave patient care in the next six years, compared to their urban counterparts. Rural-urban differences were estimated across specific subgroups of physicians (gender, race, and specialty) and with regard to specific sources of career dissatisfaction. 

The 2012 Pennsylvania Health Workforce Survey of Physicians allowed for analysis of 17,444 physicians younger than 55 years old actively practicing patient care. Multivariate, logistic regression was performed to estimate the associations with two outcome areas: career dissatisfaction and plans to leave patient care in the next six years. Controls included rural setting, age, sex, race, work hours, specialty, and practice characteristics. 

Over 12 percent of under-55 physicians are dissatisfied with their careers, and over 18 percent report plans to leave patient care in the next six years. Rural physicians in Pennsylvania have 18.6 percent higher odds of reporting career dissatisfaction and 29.5 percent higher odds of leaving patient care in the next six years (P < .01 for each) versus their urban counterparts. Rates of dissatisfaction and potential attrition among younger physicians are not insignificant, with a stronger association with rural practice. Given the large number of rural health shortage areas, better understanding this association is important to health care providers and policy makers. Regression results suggest that higher rural odds are related more to physician work (i.e., stress, practice demands, and lack of autonomy) and family situations and less related to income concerns.

This project was sponsored by a grant from the Center for Rural Pennsylvania, a legislative agency of the Pennsylvania General Assembly. The article can be accessed online.

Department of Economics