Training family physicians in community health centers: A health workforce solution

University of Washington, Department of Family Medicine, Seattle, WA 98104-2499, USA.
Family medicine (Impact Factor: 1.17). 05/2008; 40(4):271-6.
Source: PubMed


For more than 25 years, family medicine residencies (FMRs) have worked with community health centers (CHCs) to train family physicians. Despite the long history of this affiliation, little research has been done to understand the effects of training residents in this underserved community setting. This study compares CHC and non-CHC-trained family physicians regarding practice location, job and training satisfaction, and recruitment and retention to underserved areas.
We conducted a cross-sectional survey of a cohort of the 838 graduates from the WAMI (Washington, Alaska, Montana, and Idaho) Family Medicine Residency Network from 1986-2002.
CHC-trained family physicians were almost twice as likely to work in underserved settings than their non-CHC-trained counterparts (64% versus 37%). When controlling for gender, percent full-time equivalent, and years from graduation, CHC-trained family physicians were 2.7 times more likely to work in underserved settings than non-CHC-trained family physicians. CHC and non-CHC-trained family physicians report similar job and training satisfaction and scope of practice.
Training family physicians in CHCs meets the health workforce needs of the underserved, enhances the recruitment of family physicians to CHCs, and prepares family physicians similarly to their non-CHC trained counterparts.

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    • "Also, public healthcare systems still contend with high provider turnover and chronically understaffed facilities (Hurley, Felland, & Lauer, 2007; Savageau, Ferguson, Bohlke, Cragin, & O'Connell, 2011). Factors that contribute to provider and professional personnel recruitment and retention challenges include disproportionate staffing of family practice physicians (Rosenblatt, Andrilla, Curtin, & Hart, 2006), limited training opportunities in community health centers (Ferguson, Cashman, Savageau, & Lasser, 2009; Morris, Johnson, Kim, & Chen, 2008), lack of income potential, and lack of opportunity for professional experiences (Daniels, VanLeit, & Skipper, 2007). "
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    ABSTRACT: Training family medicine residents in underserved settings, such as community health centers (CHCs), may provide a solution to the primary care workforce shortage. We sought to describe the facilitators and barriers to creating partnerships between CHCs and family medicine residencies (FMRs). We conducted 19 key informant interviews and 3 focus groups to identify the key factors in the CHC-FMR relationship. Audiotapes and transcripts were analyzed to identify major themes. Key informant results were validated and expanded in the focus group discussions. Four major themes describe the CHC-FMR training partnership: mission, money, quality, and administrative/governance complexity. The CHC-FMR training affiliation is a complex relationship drawn together by a shared mission of service to the underserved, enhanced financial stability, workforce improvement, and greater educational and clinical quality. The relationship is hindered by competing primary missions, chronic underfunding, complex governing institutional regulations, and administrative challenges. In addition, the focus groups offered several policy solutions to address the barriers to CHC-FMR affiliation. A successful CHC-FMR training partnership relies upon the development of a shared mission of education and service, as well as innovation and flexibility by the organizations that govern them.
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