“If Only Someone Had Told Me …”: Lessons From Rural Providers

Abstract

Purpose-Health care providers face challenges in rural service delivery due to the unique circumstances of rural living. The intersection of rural living and health care challenges can create barriers to care that providers may not be trained to navigate, resulting in burnout and high turnover. Through the exploration of experienced rural providers' knowledge and lessons learned, this study sought to inform future practitioners, educators, and policy makers in avenues through which to enhance training, recruiting, and maintaining a rural workforce across multiple health care domains.Methods-Using a qualitative study design, 18 focus groups were conducted, with a total of 127 health care providers from Alaska and New Mexico. Transcribed responses from the question, "What are the 3 things you wish someone would have told you about delivering health care in rural areas?" were thematically coded.Findings-Emergent themes coalesced into 3 overarching themes addressing practice-related factors surrounding the challenges, adaptations, and rewards of being a rural practitioner.Conclusion-Based on the themes, a series of recommendations are offered to future rural practitioners related to community engagement, service delivery, and burnout prevention. The recommendations offered may help practitioners enter communities more respectfully and competently. They can also be used by training programs and communities to develop supportive programs for new practitioners, enabling them to retain their services and help practitioners integrate into the community. Moving toward an integrative paradigm of health care delivery wherein practitioners and communities collaborate in service delivery will be the key to enhancing rural health care and reducing disparities.

Burnout in Rural Physician Assistants

“…8 There was a moderate positive relationship between feelings of professional isolation and whether the community where the practice was located was isolated (r s = 0.430, P < .01), indicating that the responding physician assistants felt professionally isolated when their practices were geographically isolated. When the isolation questions were analyzed for a correlative association to burnout, there was a weak positive relationship between the physician assistants' feelings of professional isolation and the DP (r s = 0.293, P < .01) and EE (r s = 0.273, P < .01) subscales and a moderate negative relationship between this variable and PA (r s = 20.410, P < .01), whereas geographical isolation of their practice did not correlate to burnout as strongly as the feeling of professional isolation (DP, r s = 0.169, P < .05; EE, r s = 0.091, P > .05; PA, r s = 20.175, P < .05).…”

Barriers to Substance Abuse Treatment in Rural and Urban Communities: Counselor Perspectives

“…Additionally, other research drawing on qualitative interviews conducted with rural providers of health care has found that those working in rural areas must confront a variety of unique challenges – such as maintaining confidentiality, establishing trust, limited resources, and isolation – suggesting that rural context may exacerbate the already challenging work of substance abuse treatment (Chipp et al, 2011). While limited research has confirmed the challenges of delivering substance abuse treatment in rural contexts, further research focusing on rural substance abuse treatment providers using a detail-rich qualitative approach is needed to understand the unique challenges of working in rural contexts (Chipp et al, 2011; Johnson, Brems, Warner, & Roberts, 2006).…”

“…While limited research has confirmed the challenges of delivering substance abuse treatment in rural contexts, further research focusing on rural substance abuse treatment providers using a detail-rich qualitative approach is needed to understand the unique challenges of working in rural contexts (Chipp et al, 2011; Johnson, Brems, Warner, & Roberts, 2006). …”

Mental disorders, health inequalities and ethics: A global perspective

“…Indeed, repeated demonstrations of integrity by economically established countries towards all people affected by mental illness and its burden throughout the world is a precondition for ethically sound and humane healthcare. Moreover, intensive and more appropriately attuned ethics education is critically important in understanding and addressing mental health inequalities and in the preparation of clinicians caring for people living with mental illness (Chipp et al, in press; Hoop, DiPasquale, Hernandez, & Roberts, 2008; Jain, Dunn, & Roberts, in press; Lehrmann, Hoop, Hammond, & Roberts, 2009; Roberts, Johnson, Brems, & Warner, 2008) in rural and underserved areas.…”