Improving Primary Care Retention in Medically Underserved Areas: What's a Clinic to Do?

To reduce health professional shortage areas, the National Health Service Corps has attempted to increase the number of primary care providers in underserved communities through scholarships and loan repayment. Program evaluations assessed Loan Repayment Program (LRP) propensity to work in underserved communities. The National Health Service Corps LRPs were asked about preferences for particular retention strategies and which strategies were utilized by their clinical sites. Loan Repayment Programs were asked to rank retention strategies. Loan Repayment Program top choices were competitive salary, 88%; professional development, 70%; knowledgeable/competent support staff, 59%, and professional support, 58%. Loan Repayment Programs were also asked to rank retention strategies provided by their clinical sites: professional development, 74.2%; competitive salary, 71.2%; policies that prohibit abusive behavior, 63.6%, and knowledgeable/competent support staff, 60.6%. Loan Repayment Programs indicated professional support was an important retention element. However, when asked if professional support opportunities were offered, LRP indicated that these were not in the strategies offered by sites.