Physician retention in rural communities: the perspective of experiential place integration

Rural communities across the United States continue to struggle in their attempts to recruit and retain physicians. In response to this ongoing problem, health services researchers have focused on the recruitment of physicians. More recently, however, researchers have recognized the importance of physician retention. Nonetheless, there is a scarcity of theories to explain the process of rural physician retention. This paper provides an overview of retention in health services research. It then proposes a theoretical perspective on retention called "experiential place integration." The paper subsequently presents an in-depth qualitative study of rural physician integration in Kentucky from which a practical framework of physician integration is constructed. The framework represents integration as an active developmental process based on the enhancement of security, freedom, identity and meaning in place. (C) 1997 Elsevier Science Ltd. All rights reserved