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.
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
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.
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