There is a perceived crisis facing rural medicine in British Columbia—too few physicians serving relatively too many people. Inability to attract physicians to rural communities (low recruitment) and a perceived increase in physicians leaving rural communities (low retention) suggest things are only going to get worse.
ABSTRACT: A cohort of 1979 family physicians and general practitioners from 78 communities was identified from 21 College of Physicians and Surgeons of British Columbia medical directories—1978–79 to 1998–99.
Except for the past 3 years, in communities with less than 7000 people, there has been a more or less steady overall increase in total number of physician listings since 1979 in all community groups.
The lowest population communities have the lowest year-to-year retention rates and the highest recruitment rates. Typical retention rates for communities of fewer than 7000 people are between 70% and 80%.
Typical retention rates for communities with 7000 or more people are between 85% to 90%.
Typical recruitment rates for communities of fewer than 7000 people are between 20% and 30%, and can be as high as 38%.
Recruitment rates for communities of 7000 or more are typically between 10% and 15%.
Strong anecdotal evidence has pointed to a crisis in rural medicine in BC for years, but quantitative data have been scant—until now.
A 1991 study by Kazanjian and colleagues identified that 14.8% of rural physicians (physicians living in communities of 10 000 or less) in British Columbia wished to move.22 A 1998 survey conducted by the British Columbia Medical Association revealed that almost 25% of rural physicians were considering relocation in the next year, while only 4% of urban physicians were planning to relocate.
The majority of these rural physicians were planning to move to larger communities. Factors motivating this desire to move included on-call responsibilities, daily workload issues, on-call remuneration, cultural opportunities, educational opportunities, spousal opportunities, access to specialists, and retirement.
Our data support the results of these two surveys, adding validity to the use of “intention to move” surveys as a way of monitoring physician loss from British Columbia’s rural communities. A more recent (1999) survey of British Columbia’s NIA physicians revealed that 51% of physicians were considering relocation. If this is true, one would predict that the number of physician listings for rural communities in British Columbia will continue to drop over the next few years.
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Physician retention and recruitment outside urban British Columbia (Thommasen 2000)