Personal and professional relationships, also known as social capital, were crucial to recruiting and retaining healthcare professionals in rural areas of nine states, according to a new report from the U.S. Department of Agriculture Economic Research Service.
“In the case of healthcare professionals, the relationships that they consider when making these decisions include social relationships with family, friends, and other people in the community, and professional relationships with professional colleagues, supervisors, staff, and patients,” ERS Economist John Pender, one of the authors of the study, told the Daily Yonder.
Another factor cited as important by most healthcare professionals for deciding to stay in the towns that were part of the study was their investment in their practice. That likely reflects investment in relationships with patients and others as well as investment in facilities and recruitment and training of staff, Pender said.
“While some of the findings likely hold more generally in other contexts – like the relative importance of social factors in recruiting and retaining healthcare professionals, based on our review of studies of similar issues conducted in other contexts – we cannot be sure that they apply in every context,” he said.
For example, another study found that natural amenities were a bigger factor in recruiting physicians in the northwestern U.S.
“That study found that natural amenities and recreational opportunities were among the most often cited factors as very important in physician recruitment.”
In small towns, relationships are often overlapping. Healthcare providers may know their patients or co-workers socially as well as professionally and may have family or friends as patients, he added.
The study examined 150 small rural towns with a population between 2,500 and 20,000 in nine states. The states were Arkansas, Iowa, Kansas, Louisiana, Minnesota, Mississippi, Oklahoma, Texas and Wisconsin.
Pender said this study found that factors within the control of rural communities – such as their friendliness toward newcomers, being a good place to raise a family, the quality of the local schools, and the quality of the local medical community and facilities – are among the most cited factors considered important by healthcare professionals in their decisions.
As for factors that might make recruiting healthcare professionals more difficult, Pender said a lack of some urban amenities was often cited as one of the biggest drawbacks. Community leaders, hospital and clinic administrators, and others also cited this in their responses.
“This factor was particularly important for dentists, probably because more than 80% of dentists in the study towns were sole or part owners of their practice,” he said. “After making substantial investments in the equipment, staffing, and relationships with patients necessary to have a successful practice, it is understandable that most dentists and many other healthcare practice owners would be reluctant to move elsewhere, especially considering costs that could not be recouped, such as investments in relationships.”
Although the study was conducted in many small towns in nine states, it is important to recognize that the conclusions may not apply to other contexts, Pender said.