Physician Retention in Community and Migrant Health Centers

Singer, J. David; Davidson, Stephen M.; Graham, Suzanne; Davidson, Harriet

doi:10.1097/00005650-199808000-00008

Cited by 74 publications

(42 citation statements)

References 8 publications

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“…Inasmuch as the centers are operated by nonprofit organizations that seek to provide services for poor people, staffing often relies upon physicians from the National Health Service Corps. One study of primary physician tenure at CHC-MHP health centers found that the median tenure was just three years (63). Obviously, if physician recruitment and retention is a serious problem, the imposition of language or cultural familiarity requirements during recruitment are out of the question.…”

Section: Access To Health Care Servicesmentioning

confidence: 99%

The Health of U.S. Hired Farm Workers

Villarejo¹

2003

Annu. Rev. Public Health

272

271

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Key Words farm worker, migrant labor, occupational health and safety, Hispanic health, minority health s Abstract Despite a recent surge in knowledge about U.S. hired farm workers, little is known about the health of this population. No national data are available on the size of the population, mortality or morbidity data, or on chronic health indicators. Demographic data show that these workers are mostly Mexican immigrant or migrant males, and nearly two thirds live in poverty. At least half of all current hired farm workers are undocumented. Fewer than one in five have health insurance, either through their employer or through government programs. However, programs targeting women farm workers, such as WIC or, in California, emergency MediCal, are more effective in helping them obtain needed services. The federal Migrant Health Program serves about 13% of the total of workers plus dependent family members. This paper reviews what is known in the following topical areas: (a) mortality and morbidity; (b) access to health care services; (c) control of infectious diseases; (d ) maternal and child care; (e) occupational health; ( f ) violence; and (g) chronic health indicators. It is suggested that future research incorporate a minimal physical examination of all patients or subjects in order to establish baseline information for the population. Such information will be helpful in targeting interventions and measuring their effectiveness.

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Section: Access To Health Care Servicesmentioning

confidence: 99%

The Health of U.S. Hired Farm Workers

Villarejo¹

2003

Annu. Rev. Public Health

272

271

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“…2,6 Discrete-time survival analysis of physicians working in community and migrant health services in the United States (US) found that the mean period of tenure of primary care physicians working in these areas was only 3 years. 7 Working with disadvantaged and marginalised patients can pose challenges for physicians, whose roles often expand to include advocacy and coordination of complex patient journeys through the health system. 2,8 When these roles are shoehorned into busy general practices, GPs report feeling overwhelmed.…”

Section: Introductionmentioning

confidence: 99%

Resilience among doctors who work in challenging areas: a qualitative study

Stevenson¹,

Phillips²,

Anderson³

2011

Br J Gen Pract

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“…[4][5][6][7][8][9] Physicians have compelling reasons to avoid practicing among the poor. Physicians who choose to work in underserved settings often forgo academic opportunities, professional prestige, 7 and free time, 10 and accept reduced salaries, diminished control over the work environment, 4 and increased bureaucratic interference. 10 These and other extrinsic 11,12 and objective 13 workplace characteristics diminish the appeal of underserved settings.…”

Section: Introductionmentioning

confidence: 99%

Do Religious Physicians Disproportionately Care for the Underserved?

Curlin

Dugdale

Lantos

et al. 2007

The Annals of Family Medicine

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PURPOSE Religious traditions call their members to care for the poor and marginalized, yet no study has examined whether physicians' religious characteristics are associated with practice among the underserved. This study examines whether physicians' self-reported religious characteristics and sense of calling in their work are associated with practice among the underserved.METHODS This study entailed a cross-sectional survey by mail of a stratifi ed random sample of 2,000 practicing US physicians from all specialties. RESULTSThe response rate was 63%. Twenty-six percent of US physicians reported that their patient populations are considered underserved. Physicians who were more likely to report practice among the underserved included those who were highly spiritual (multivariate odds ratio [OR] = 1.7; 95% confi dence interval [CI], 1.1-2.7], those who strongly agreed that their religious beliefs infl uenced their practice of medicine (OR = 1.6; 95% CI, 1.1-2.5), and those who strongly agreed that the family in which they were raised emphasized service to the poor (OR = 1.7; 95% CI, 1.0-2.7). Physicians who were more religious in general, as measured by intrinsic religiosity or frequency of attendance at religious services, were much more likely to conceive of the practice of medicine as a calling but not more likely to report practice among the underserved.CONCLUSIONS Physicians who are more religious do not appear to disproportionately care for the underserved. INTRODUCTIONC odes of medical ethics have called physicians to care for the poor for centuries, from the birth of the Hippocratic tradition in ancient Greece, 1 through the middle ages in Europe, 2 and into modern America. 3 In spite of such ongoing moral exhortation, many poor patients and communities continue to be medically underserved. [4][5][6][7][8][9] Physicians have compelling reasons to avoid practicing among the poor. Physicians who choose to work in underserved settings often forgo academic opportunities, professional prestige, 7 and free time, 10 and accept reduced salaries, diminished control over the work environment, 4 and increased bureaucratic interference. 10 These and other extrinsic 11,12 and objective 13 workplace characteristics diminish the appeal of underserved settings.Although the poor are underserved, they are not unserved; many physicians choose to practice in underserved settings. Those who do tend to identify intrinsic and intangible rewards of their work, such as making a difference in society, having a positive impact on the lives of patients who are otherwise marginalized, and living in a way congruent with their personal hopes and aspirations. 10,14 These subjective rewards express ways in which physicians may relate to their work among the underserved more as a calling than as a job. R EL IGIOUS PHY SICIA NS A ND T HE UNDER SERV EDThe concept of calling is currently used in the work literature to refer broadly to work done with a sense of inner direction and aimed at improving the world. 13,15 In the words of...

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Physician Retention in Community and Migrant Health Centers

Cited by 74 publications

References 8 publications

The Health of U.S. Hired Farm Workers

The Health of U.S. Hired Farm Workers

Resilience among doctors who work in challenging areas: a qualitative study

Do Religious Physicians Disproportionately Care for the Underserved?

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