1. Where We Live: Retaining Physicians in Rural Communities in Alberta Pamela J. Cameron, PhD Candidate David C. Este, PhD Faculty of Social Work, University of Calgary pjcamero@ucalgary.ca

2. Background Rural physicians foster health promotion, maintenance and community sustainability Accessing health services locally can be challenging Less is known about physician retention Community’s role is largely uninvestigated

3. Purpose 1.Describe the characteristics of four successful rural communities 2.Identify specific retention factors and strategies and explore the actual and potential role of the community in retention 3.Generate ‘lessons learned’ that also may be extrapolated to other professional groups

4. Methods Qualitative, collective case study Four rural communities (cases) that retained FP/GP for four years or longer Participants: physicians, spouses, staff members and community members Data Collection: interviews, documents, observations

5. Analysis Data collected were analyzed using ATLAS.ti® for each case Similarities and differences between cases were also analyzed

6. Findings Despite differences (geography, size, amenities), professional, personal and community factors emerged Factors such as scope of practice, spousal and family support and active support from the community impacted physicians’ decisions to stay

7. Findings …you stay because you feel connected to the community. You stay because, yeah, you’re part of it more than anyone – more than your urban counterpart can feel…you stay cause you’re integrated into a community that you like [Female physician]. They’ve earned a level of respect but they give good health care and we know they do give health care. They care, and so we care as a community [Male community member].

8. Findings Recruitment strategies were often formal. Retention strategies were largely informal There is no “one size fits all” retention solution Retention is multifaceted

9. Implications Physicians, community and policymakers have actual and potential roles in maintaining and enhancing retention Strategies and factors identified may be explored by physicians, policymakers and communities interested in retaining rural health professionals

10. Acknowledgements Participants for their time and perspectives Social Sciences and Humanities Research Council of Canada (SSHRC), Alberta Rural Physician Action Plan (RPAP), Faculty of Social Work, U of C

11. Related Literature Cutchin, M. P. (1997a). Community and self: concepts for rural physician integration and retention. Soc.Sci.Med., 44, 1661-1674. DesMeules, M., Pong, R. W., Lagace, C., Heng, D., Manuel, D., Pitblado, R. J. et al. (2006). How Healthy Are Rural Canadians? An Assessment of Their Health Status and Health Determinants Ottawa, Ontario: Canadian Institute for Health Information. Hays, R., Wynd, S., Veitch, C., & Crossland, L. (2003). Getting the balance right? GPs who chose to stay in rural practice. Aust.J.Rural.Health, 11, 193-198. Ministerial Advisory Council on Rural Health (2002). Rural Health in Rural Hands: Strategic Directions for Rural, Remote, Northern and Aboriginal Communities. Ottawa, Ontario: Ministerial Advisory Council on Rural Health, Health Canada.