Following the call: how providers make sense of their decisions to work in faith-based and secular urban community health centers.

We interviewed 49 health care providers from 6 faith-based and 4 secular community health centers (CHCs) to explore the ways they relate their religious commitments to practice among the underserved. Interviews were transcribed, coded, and analyzed for emergent themes through an iterative process of textual analysis. Providers in faith-based CHCs explained the decision to work in underserved settings as a response to a religious calling to medicine as a means of ministry, and by reference to particular benefits and freedoms of working with colleagues who share an explicitly faith-informed vision for care of the underserved. Most providers from secular CHCs explained their motivations in less religious terms by reference to intrinsic rewards such as "making a difference" for the underserved. Providers from both settings emphasized the frustrations and difficulties of meeting overwhelming demands with inadequate resources. In light of prior literature regarding work orientation, our findings suggest that CHCs may provide distinctive opportunities for intrinsically motivated providers to craft their work into a calling, where a calling is understood as a deeply felt motivation for work that goes beyond the satisfaction of the worker's material and social needs. Faith-based CHCs appear to provide a context that is attractive to some minority of providers who desire to enact a religious calling to ministry through the practice of medicine. Future studies are needed to test these hypotheses using quantitative methods and broader representative sampling.