OBJECTIVE: To assess the effect of decentralized training programs, financial incentives, and physicians' origins on whether general practitioners continue to practise in an area. DESIGN: Our data were obtained from the physician database maintained by the Bas-Saint-Laurent Regional Department of Health and Social Services and from responses to a mailed questionnaire completed by physicians in the study. SETTING: The Lower St. Lawrence Region of Quebec. PARTICIPANTS: General practitioners who practised in the area between 1985 and 2003. METHOD: We used the Cox proportional hazards model of survival analysis to ascertain which variables were related to retaining physicians in the area. RESULTS: The adjusted probability of physicians remaining in Bas-Saint-Laurent after being exposed to the area through rural rotations had an odds ratio of 2.12 (P = .15). The probability of remaining in the area climbed to an odds ratio of 4.5 (P < .01) for physicians originally from the Bas-Saint-Laurent region. Financial incentives appeared to make little difference to whether physicians were retained in the area. CONCLUSION: The most promising strategies for retaining rural general practitioners are recruiting candidates from rural areas and exposing medical students to rural practice through decentralized training.
OBJECTIVE: To assess the effect of decentralized training programs, financial incentives, and physicians' origins on whether general practitioners continue to practise in an area. DESIGN: Our data were obtained from the physician database maintained by the Bas-Saint-Laurent Regional Department of Health and Social Services and from responses to a mailed questionnaire completed by physicians in the study. SETTING: The Lower St. Lawrence Region of Quebec. PARTICIPANTS: General practitioners who practised in the area between 1985 and 2003. METHOD: We used the Cox proportional hazards model of survival analysis to ascertain which variables were related to retaining physicians in the area. RESULTS: The adjusted probability of physicians remaining in Bas-Saint-Laurent after being exposed to the area through rural rotations had an odds ratio of 2.12 (P = .15). The probability of remaining in the area climbed to an odds ratio of 4.5 (P < .01) for physicians originally from the Bas-Saint-Laurent region. Financial incentives appeared to make little difference to whether physicians were retained in the area. CONCLUSION: The most promising strategies for retaining rural general practitioners are recruiting candidates from rural areas and exposing medical students to rural practice through decentralized training.