To stay or not to stay: the role of sense of belonging in the retention of physicians in rural areas

Abstract

Rural communities across the circumpolar region and worldwide perennially suffer from physician shortages despite decades of attempting targeted strategies for recruitment. Particularly in rural Canada, financial incentives have attracted but not retained a medical workforce. Although the importance of social connection or belonging is a long-established source of well-being, such information has not infiltrated the dialogue or action on physician retention in rural areas. A physician’s sense of belonging, arising from that emotional need for social connectedness, is built via bilateral active efforts at community engagement, reciprocity, social integration of family and workplace collegiality. Links between rural upbringing, rural training opportunities and subsequent rural practice likely rest upon fostering this sense of belonging. Policymakers and recruiters might consider how to help physicians adapt, “fit in”, and consider they have “come home” when they venture off to rural settings. Empowering the community to be involved in the recruitment and retention of rural physicians may also be effective. Perhaps this approach would better address the age-old battle to retain physicians in rural Canada and around the world.

A scoping review on the barriers to and facilitators of health services utilisation related to refugee settlement in regional or rural areas of the host country

“…However, these issues are greatly accentuated in rural areas, which also have unique challenges such as reduced public transport facilities, a lack of primary and specialist healthcare professionals, and low employment opportunities. It is recognised that people living in rural areas experience significant shortfalls in health services access [ 59 ], which is further exacerbated by physicians’ personal and professional goals being unfulfilled, as well as a lack of sense of belonging in the communities [ 60 , 61 ]. Unfortunately, when combined with underemployment and rising healthcare costs, this affects access to appropriate healthcare and adds to the mental stress already experienced by refugees [ 62 ].…”

Sense of belonging is a critical component of workforce retention

“…Additional measures that can improve wellbeing and help retain staff, include mentoring (especially early in employment), promoting a positive social environment, and strategies that promote team based culture 202122. Studies conducted in the US, UK, and Canada indicate that when employers and employees work together to mitigate harassment, discrimination, and stress, they support an environment that reflects all employees, improves work-life balance, and reduces attrition rates 23242526…”

A scoping review on the barriers to and facilitators of health services utilisation related to refugee settlement in regional or rural areas of the host country

“…Lack of resources in terms of public transport facilities, primary and specialist healthcare professionals, employment opportunities, and healthcare costs are all major issues. It was acknowledged that people living in rural areas face a lack of health infrastructure [56], which is partially due to physicians' personal and professional goals being unful lled as well as a lack of sense of belonging in the communities [57,58]. Unfortunately, when combined with underemployment and rising healthcare costs, this affects access to appropriate healthcare and adds to the mental stress already experienced by refugees [59].…”