School of Medicine and Health Sciences Poster Presentations

Title

Understanding Physician Commitment to Practice in Urban Medically Underserved Communities

Document Type

Poster

Abstract Category

Prevention and Community Health

Keywords

physician commitment, healthcare workforce, underserved communities

Publication Date

Spring 5-1-2019

Abstract

Nationally, over 84 million Americans live in areas that do not have access to a sufficient number of primary care providers, with the majority being in low socioeconomic urban areas. Many physicians who are recruited or choose to practice in these areas leave after several years, while others remain. Limited empirical research has addressed the experiences of the physicians who choose to stay. Choosing to maintain a career practice in these communities indicates a commitment. Commitment defined as the psychological force that binds an individual to a target or course of action of relevance to that target, is highly correlated with job retention. There is limited understanding of physicians’ experiences that lead to and sustain their commitment to practice in underserved communities. This hermeneutic phenomenological study explored the experience of physician commitment to practice long-term in an urban medically underserved community. It explored how this process developed in these physicians, as well as the influences that strengthened and/or weakened commitment. In-depth interviews of eleven primary care physicians who practice in underserved cities for seven years or greater were analyzed. Four primary findings emerged from this study: 1. Primary commitment of these physicians was to underserved communities in general and their specific community. Secondary commitment was to their practice clinic organization. 2. Commitment involved: embracing satisfying activities; actualizing individual values; enacting identity; and facing/resolving challenges. 3. Commitment is sustained and reinforced through the intersection of these characteristics. 4. Commitment developed through the merging of commitment to profession with commitment to the underserved. Family, religious upbringing, mentors, and nontraditional educational routes contribute to the development. This study shows the complexity of the commitment of physicians practicing in underserved communities, broadens the view of commitment as it is applied to organizations, and has implications for policies for health professional retention.

Open Access

1

Comments

Presented at Research Days 2019.

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Understanding Physician Commitment to Practice in Urban Medically Underserved Communities

Nationally, over 84 million Americans live in areas that do not have access to a sufficient number of primary care providers, with the majority being in low socioeconomic urban areas. Many physicians who are recruited or choose to practice in these areas leave after several years, while others remain. Limited empirical research has addressed the experiences of the physicians who choose to stay. Choosing to maintain a career practice in these communities indicates a commitment. Commitment defined as the psychological force that binds an individual to a target or course of action of relevance to that target, is highly correlated with job retention. There is limited understanding of physicians’ experiences that lead to and sustain their commitment to practice in underserved communities. This hermeneutic phenomenological study explored the experience of physician commitment to practice long-term in an urban medically underserved community. It explored how this process developed in these physicians, as well as the influences that strengthened and/or weakened commitment. In-depth interviews of eleven primary care physicians who practice in underserved cities for seven years or greater were analyzed. Four primary findings emerged from this study: 1. Primary commitment of these physicians was to underserved communities in general and their specific community. Secondary commitment was to their practice clinic organization. 2. Commitment involved: embracing satisfying activities; actualizing individual values; enacting identity; and facing/resolving challenges. 3. Commitment is sustained and reinforced through the intersection of these characteristics. 4. Commitment developed through the merging of commitment to profession with commitment to the underserved. Family, religious upbringing, mentors, and nontraditional educational routes contribute to the development. This study shows the complexity of the commitment of physicians practicing in underserved communities, broadens the view of commitment as it is applied to organizations, and has implications for policies for health professional retention.