Physician retention in four rural communities in Alberta: A collective case study

Accessing health services locally can be challenging for residents of rural communities. Rural health professionals such as nurses, social workers, and physicians are instrumental to the health and wellbeing of community members, and to community sustainability. While studies regarding physician recruitment are plentiful, less is known about physician retention. An examination of the role of the community in retaining physicians is relatively unexplored in the literature. A qualitative, collective case study design was employed to study four rural communities (cases) in Alberta that retained family physicians for four years or longer. Participants included physicians, staff members, spouses, and community members. Communities were selected through a retention-specific matrix; each quadrant represented a particular retention typology. Data collected from interviews, documents, and observations were analyzed using ATLAS.ti ^® for each case. Similarities and differences between cases were also analyzed. Despite differences in geography, size, and community amenities, there were a number of professional, personal, and community factors that commonly influenced retention. Factors such as scope of practice, spousal and family support, and active support from the community impacted rural physicians’ decisions to stay in these communities. Physicians, staff, community, and policymakers could have actual and potential roles in maintaining and enhancing retention. Physician retention in rural communities in Alberta is multifaceted, involving various groups, supports, and assets. The retention factors identified and the lessons learned through this research may be a resource for physicians, policymakers, and other communities interested in retaining rural health professionals.