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Journal articles on the topic 'Rural doctors'

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Published: 4 June 2021

Last updated: 20 February 2023

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1

Li, Jinhu, Anthony Scott, Matthew McGrail, John Humphreys, and Julia Witt. "Retaining rural doctors: Doctors' preferences for rural medical workforce incentives." Social Science & Medicine 121 (November 2014): 56–64. http://dx.doi.org/10.1016/j.socscimed.2014.09.053.

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2

Chiu, Ya-Ling, Jying-Nan Wang, Haiyan Yu, and Yuan-Teng Hsu. "Consultation Pricing of the Online Health Care Service in China: Hierarchical Linear Regression Approach." Journal of Medical Internet Research 23, no. 7 (July 14, 2021): e29170. http://dx.doi.org/10.2196/29170.

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Background Online health care services are a possible solution to alleviate the lack of medical resources in rural areas, and further understanding of the related medical service pricing system would contribute to improvement of the online health care community (OHC). Although many studies have investigated the OHC, the impact of physicians’ reputations and wage levels on consulting prices in the OHC has rarely been discussed in the literature. Objective This study was designed to explore the determinants of consulting prices in the OHC. We addressed the following questions: (1) Are the prices of online health consultation services affected by wage levels at the doctor’s location? (2) How does a physician’s online and offline reputation affect their consulting prices? Methods Employing a large-scale sample of 16,008 doctors in China, we first used descriptive statistics to investigate the determinants of consulting prices in their entirety. Hierarchical linear modeling was then used to investigate the determinants of consulting prices in the OHC. Results The empirical results led to the conclusion that if doctors have more elevated clinic titles, work in higher-level hospitals, have better online reputations, and/or have made more past sales, their consulting prices will be higher. Additionally, the wage level in the city in which the doctor is working determines their opportunity cost and therefore also affects consulting prices. Conclusions The findings indicate that the characteristics of the doctor, the doctor’s online reputation, and past sales affect the consulting price. In particular, the wage level in the city affects the price of the consultation. These findings highlight that the OHC is important because it can indeed break through geographical restrictions and give rural residents the opportunity to obtain medical service from doctors in big cities. However, doctors from cities often charge higher fees because of their higher opportunity cost. The results reveal that one of the most important functions of the OHC is to reduce the medical disparity between urban and rural areas; however, planners appear to ignore the possibility that rural residents with lower incomes may not be able to afford such high medical consultation costs. Therefore, the government should consider providing incentives to encourage urban doctors to provide discounts to rural residents or directly offer appropriate subsidies.

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MAGNUS, J. H., and A. TOLLAN. "Rural doctor recruitment: does medical education in rural districts recruit doctors to rural areas?" Medical Education 27, no. 3 (May 1993): 250–53. http://dx.doi.org/10.1111/j.1365-2923.1993.tb00264.x.

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4

Chen, Qiwei, Lan Yang, Qiming Feng, and Scott S. Tighe. "Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital." Scientifica 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/1964087.

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Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39) of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39) mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39) showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor’s relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

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Kinchagulova, Miliausha V., N. S. Brynza, O. P. Gorbunova, and Yu S. Reshetnikova. "THE RESULTS OF “ZEMSKY DOCTOR” PROGRAM IN TYUMEN REGION." Health Care of the Russian Federation 62, no. 6 (May 24, 2019): 289–94. http://dx.doi.org/10.18821/0044-197x-2018-62-6-289-294.

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The problem of the availability of doctors and nurses is particularly relevant in rural areas. The purpose of the study is to assess the effectiveness of the implementation of the Zemsky Doctor program in the Tyumen Region. To achieve the goal, a number of tasks were solved: analysis of number, composition and movement of program participants; analysis of the impact of the program on the availability of doctors in the rural population; analysis of the reasons for early termination of contracts. Materials and methods. The study was conducted by the Tyumen State Medical University of the Ministry of Health of Russia with the assistance of the Health Department of the Tyumen Region in 2018 on the basis of processing and analyzing statistical data on 520 doctors who participated in the Zemsky Doctor program in the Tyumen Region (without autonomous districts). Results. The main reason for early termination of contracts on the initiative of the program participant is the acquisition of housing in another settlement. The analysis showed that the majority of early termination of contracts falls on recipients of payments in 2012-2014. Discussion. The criterion of effectiveness of the program is the provision of doctors for the population. The analysis led to the conclusion that “Zemsky Doctor” program contributed to the improvement of the rural population’s supply of doctors, at the same time, the annual average growth rate of provision of doctors during the period of the program implementation was 5,7%, the maximum value of the indicator was noted in 2015-2016. Currently, the problem of retaining recruited specialists in rural areas is particularly relevant. Conclusion. The results of study can be used by regional authorities, management of medical organizations when deciding on the further implementation of Zemsky Doctor program, as well as in making managerial decisions on the issues of human resources for rural healthcare generally.

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6

Hoyal, Francis M. D. "RETENTION OF RURAL DOCTORS." Australian Journal of Rural Health 3, no. 1 (February 1995): 2–9. http://dx.doi.org/10.1111/j.1440-1584.1995.tb00139.x.

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7

Gross, Miriam. "Between Party, People, and Profession: The Many Faces of the ‘Doctor’ during the Cultural Revolution." Medical History 62, no. 3 (June 11, 2018): 333–59. http://dx.doi.org/10.1017/mdh.2018.23.

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During the Chinese Cultural Revolution (1966–76), Chairman Mao fundamentally reformed medicine so that rural people received medical care. His new medical model has been variously characterised as: revolutionary Maoist medicine, a revitalised form of Chinese medicine; and the final conquest by Western medicine. This paper finds that instead of Mao’s vision of a new ‘revolutionary medicine’, there was a new medical synthesis that drew from the Maoist ideal and Western and Chinese traditions, but fundamentally differed from all of them. Maoist medicine’s ultimate aim was doctors as peasant carers. However, rural people and local governments valued treatment expertise, causing divergence from this ideal. As a result, Western and elite Chinese medical doctors sent to the countryside for rehabilitation were preferable to barefoot doctors and received rural support. Initially Western-trained physicians belittled elite Chinese doctors, and both looked down on barefoot doctors and indigenous herbalists and acupuncturists. However, the levelling effect of terrible rural conditions made these diverse conceptions of the doctor closer during the Cultural Revolution. Thus, urban doctors and rural medical practitioners developed a symbiotic relationship: barefoot doctors provided political protection and local knowledge for urban doctors; urban doctors’ provided expertise and a medical apprenticeship for barefoot doctors; and both counted on the local medical knowledge of indigenous healers. This fragile conceptual nexus had fallen apart by the end of the Maoist era (1976), but the evidence of new medical syntheses shows the diverse range of alliances that become possible under the rubric of ‘revolutionary medicine’.

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8

Cuesta-Briand, Beatriz, Mathew Coleman, Rebekah Ledingham, Sarah Moore, Helen Wright, David Oldham, and Denese Playford. "Extending a Conceptual Framework for Junior Doctors’ Career Decision Making and Rural Careers: Explorers versus Planners and Finding the ‘Right Fit’." International Journal of Environmental Research and Public Health 17, no. 4 (February 20, 2020): 1352. http://dx.doi.org/10.3390/ijerph17041352.

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This study uses data from a Rural Clinical School of Western Australia (RCSWA) and WA Country Health (WACHS) study on rural work intentions among junior doctors to explore their internal decision-making processes and gain a better understanding of how junior doctors make decisions along their career pathway. This was a qualitative study involving junior doctor participants in postgraduate years (PGY) 1 to 5 undergoing training in Western Australia (WA). Data was collected through semi-structured telephone interviews. Two main themes were identified: career decision-making as an on-going process; and early career doctors’ internal decision-making process, which fell broadly into two groups (‘explorers’ and ‘planners’). Both groups of junior doctors require ongoing personalised career advice, training pathways, and career development opportunities that best “fit” their internal decision-making processes for the purposes of enhancing rural workforce outcomes.

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Angell, Blake, Mushtaq Khan, Mir Raihanul Islam, Kate Mandeville, Nahitun Naher, Eleanor Hutchinson, Martin McKee, Syed Masud Ahmed, and Dina Balabanova. "Incentivising doctor attendance in rural Bangladesh: a latent class analysis of a discrete choice experiment." BMJ Global Health 6, no. 7 (July 2021): e006001. http://dx.doi.org/10.1136/bmjgh-2021-006001.

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ObjectiveDoctor absenteeism is widespread in Bangladesh, and the perspectives of the actors involved are insufficiently understood. This paper sought to elicit preferences of doctors over aspects of jobs in rural areas in Bangladesh that can help to inform the development of packages of policy interventions that may persuade them to stay at their posts.MethodsWe conducted a discrete choice experiment with 308 doctors across four hospitals in Dhaka, Bangladesh. Four attributes of rural postings were included based on a literature review, qualitative research and a consensus-building workshop with policymakers and key health-system stakeholders: relationship with the community, security measures, attendance-based policies and incentive payments. Respondents’ choices were analysed with mixed multinomial logistic and latent class models and were used to simulate the likely uptake of jobs under different policy packages.ResultsAll attributes significantly impacted doctor choices (p<0.01). Doctors strongly preferred jobs at rural facilities where there was a supportive relationship with the community (β=0.93), considered good attendance in education and training (0.77) or promotion decisions (0.67), with functional security (0.67) and higher incentive payments (0.5 per 10% increase of base salary). Jobs with disciplinary action for poor attendance were disliked by respondents (−0.63). Latent class analysis identified three groups of doctors who differed in their uptake of jobs. Scenario modelling identified intervention packages that differentially impacted doctor behaviour and combinations that could feasibly improve doctors’ attendance.ConclusionBangladeshi doctors have strong but varied preferences over interventions to overcome absenteeism. We generated evidence suggesting that interventions considering the perspective of the doctors themselves could result in substantial reductions in absenteeism. Designing policy packages that take account of the different situations facing doctors could begin to improve their ability and motivation to be present at their job and generate sustainable solutions to absenteeism in rural Bangladesh.

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Gu, Linni, Rui Zhu, Zhen Li, Shengfa Zhang, Jing Li, Donghua Tian, and Zhijun Sun. "Factors Associated with Rural Residents’ Contract Behavior with Village Doctors in Three Counties: A Cross-Sectional Study from China." International Journal of Environmental Research and Public Health 17, no. 23 (December 2, 2020): 8969. http://dx.doi.org/10.3390/ijerph17238969.

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Historically, cooperative medical insurance and village doctors are considered two powerful factors in protecting rural residents’ health. However, with the central government of China’s implementation of new economic policies in the 1980s, cooperative medical insurance collapsed and rural residents fell into poverty because of sickness. In 2009, the New Rural Cooperative Medical Insurance (NRCMI) was implemented to provide healthcare for rural residents. Moreover, the National Basic Drug System was implemented in the same year to protect rural residents’ right to basic drugs. In 2013, a village doctor contract service was implemented after the publication of the Guidance on Pilot Contract Services for Rural Doctors. This contract service aimed to retain patients in rural primary healthcare systems and change private practice village doctors into general practitioners (GPs) under government management. Objectives: This study investigates the factors associated with rural residents’ contract behavior toward village doctors. Further, we explore the relationships between trust, NRCMI reimbursement rate, and drug treatment effect. We used a qualitative approach, and twenty-five village clinics were chosen from three counties as our study sites using a random sampling method. A total of 625 villagers participated in the investigation. Descriptive analysis, chi-squared test, t-test, and hierarchical logistic analyses were used to analyze the data. Results: The chi-squared test showed no significant difference in demographic characteristics, and the t-test showed a significant difference between signed and unsigned contract services. The results of the hierarchical logistic analysis showed that trust significantly influenced patients’ willingness to contract services, and the drug treatment effect and NRCMI reimbursement rate moderated the influence of trust. Conclusion: Our findings suggest that the government should aim to strengthen trust in the doctor–patient relationship in rural areas and increase the NRCMI reimbursement rate. Moreover, health officers should perfect the contract service package by offering tailored contract services or expanding service packages.

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Zhao, Xinyi, Shu Liu, Yifan Chen, Quan Zhang, and Yue Wang. "Influential Factors of Burnout among Village Doctors in China: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 18, no. 4 (February 19, 2021): 2013. http://dx.doi.org/10.3390/ijerph18042013.

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(1) Background: The heavy workload and understaffed personnel of village doctors is a challenge to the rural healthcare system in China. Previous studies have documented the predictors of doctors’ burnout; however, little attention has been paid to village doctors. This study aims to investigate the prevalence and influential factors of burnout among village doctors. (2) Methods: Data was collected by a self-administered questionnaire from 1248 village doctors who had worked at rural clinics for more than a year. Burnout was measured using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) with three dimensions—emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). A logistic regression model was applied to estimate the influential factors of burnout. (3) Results: The prevalence of overall burnout was 23.6%. Being male (OR = 0.58, 95%CI: 0.41–0.82), poor health status (OR = 0.80, 95%CI: 0.67–0.94), low income (OR = 0.62, 95%CI: 0.40–0.95), and a poor doctor–patient relationship (OR = 0.57, 95%CI: 0.48–0.67) were significantly related to burnout. Conclusion: Burnout is prevalent among Chinese village doctors. Policies such as increasing village doctors’ income and investing more resources in rural healthcare system should be carried out to mitigate and prevent burnout.

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12

Mildenhall, David. "Rural doctors and medical rosters." Medical Journal of Australia 178, no. 7 (April 2003): 341–42. http://dx.doi.org/10.5694/j.1326-5377.2003.tb05228.x.

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13

Shuster, Arthur. "What should rural doctors expect?" University of Western Ontario Medical Journal 83, no. 1 (December 23, 2014): 32–33. http://dx.doi.org/10.5206/uwomj.v83i1.4494.

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14

Hays, Richard B., P. Craig Veitch, Brian Cheers, and Lisa Crossland. "WHY DOCTORS LEAVE RURAL PRACTICE." Australian Journal of Rural Health 5, no. 4 (November 1997): 198–203. http://dx.doi.org/10.1111/j.1440-1584.1997.tb00267.x.

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15

Wainer, Jo. "WORK OF FEMALE RURAL DOCTORS." Australian Journal of Rural Health 12, no. 2 (June 28, 2008): 49–53. http://dx.doi.org/10.1111/j.1440-1584.2004.tb00568.x.

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Wainer, Jo. "Work of Female Rural Doctors." Australian Journal of Rural Health 12, no. 2 (April 2004): 49–53. http://dx.doi.org/10.1111/j.1038-5282.2004.00557.x.

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17

Clark, Tyler R., Saul B. Freedman, Amanda J. Croft, Hazel E. Dalton, Georgina M. Luscombe, Anthony M. Brown, David J. Tiller, and Michael S. Frommer. "Medical graduates becoming rural doctors: rural background versus extended rural placement." Medical Journal of Australia 199, no. 11 (December 2013): 779–82. http://dx.doi.org/10.5694/mja13.10036.

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18

Giamto, Kristian Wongso. "Empowering Rural-Remote Doctors Through Distance CME: a Literature Study." Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education 5, no. 1 (March 27, 2016): 45. http://dx.doi.org/10.22146/jpki.25310.

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Background: Doctors in rural and remote areas in eastern Indonesia, particularly North Maluku (northern part of the Moluccas Islands), are burdened with difficulties in their daily practice due to shortage of radiology or laboratory devices and other medical specialties. Travel distance and cost sometimes made referral to a better health facility impossible. They also have limited accessibility to live Continuing Medical Education (CME), due to relatively high travel cost and limited health professionals remaining while they are absent. However, in this challenging situation, they still obliged to deliver the most optimal medical services possible. In some ways, such setting is more challenging than working as a doctor in urban area.Method: This paper derived its data from scientific journal publications, newspaper and also direct interview.Results: Online CME may be a very promising method to empower doctors in rural and remote settings. More awareness to the significance of CME, especially, to rural and remote doctors is needed. Further advocacy and collaboration among stakeholders are needed to support this idea, which is relevant not only to rural and remote doctors in North Maluku, but also in other eastern parts, and perhaps in other remote areas in entire Indonesia.Conclusion: Online CME, as proven by evidence-based findings, will reduce professional isolation and equip them cognitively. This empowerment will ultimately benefit patients and, indirectly, other sectors as well.

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Brodribb, Wendy, Maria Zadoroznyj, and Bill Martin. "How do rural placements affect urban-based Australian junior doctors’ perceptions of working in a rural area?" Australian Health Review 40, no. 6 (2016): 655. http://dx.doi.org/10.1071/ah15127.

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Objectives The aim of the present study was to provide qualitative insights from urban-based junior doctors (graduation to completion of speciality training) of the effect of rural placements and rotations on career aspirations for work in non-metropolitan practices. Methods A qualitative study was performed of junior doctors based in Adelaide, Brisbane and Melbourne. Individual face-to-face or telephone semistructured interviews were held between August and October 2014. Thematic analysis focusing on participants’ experience of placements and subsequent attitudes to rural practice was undertaken. Results Most participants undertook rural placements in the first 2 years after graduation. Although experiences varied, positive perceptions of placements were consistently linked with the degree of supervision and professional support provided. These experiences were linked to attitudes about working outside metropolitan areas. Participants expressed concerns about being ‘forced’ to work in non-metropolitan hospitals in their first postgraduate year; many received little warning of the location or clinical expectations of the placement, causing anxiety and concern. Conclusions Adequate professional support and supervision in rural placements is essential to encourage junior doctors’ interests in rural medicine. Having a degree of choice about placements and a positive and supported learning experience increases the likelihood of a positive experience. Doctors open to working outside a metropolitan area should be preferentially allocated an intern position in a non-metropolitan hospital and rotated to more rural locations. What is known about the topic? The maldistribution of the Australian medical workforce has led to the introduction of several initiatives to provide regional and rural experiences for medical students and junior doctors. Although there have been studies outlining the effects of rural background and rural exposure on rural career aspirations, little research has focused on what hinders urban-trained junior doctors from pursuing a rural career. What does this paper add? Exposure to medical practice in regional or rural areas modified and changed the longer-term career aspirations of some junior doctors. Positive experiences increased the openness to and the likelihood of regional or rural practice. However, junior doctors were unlikely to aspire to non-metropolitan practice if they felt they had little control over and were unprepared for a rural placement, had a negative experience or were poorly supported by other clinicians or health services. What are the implications for practitioners? Changes to the process of allocating junior doctors to rural placements so that the doctors felt they had some choice, and ensuring these placements are well supervised and supported, would have a positive impact on junior doctors’ attitudes to non-metropolitan practice.

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Taneja, DK. "Rural doctors course: Need and challenges." Indian Journal of Public Health 54, no. 1 (2010): 1. http://dx.doi.org/10.4103/0019-557x.70534.

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Baker, Tim. "Providing a lifeline for rural doctors." Medical Journal of Australia 203, no. 7 (October 2015): 277. http://dx.doi.org/10.5694/mja15.00768.

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22

Pearson, Alan. "Nurses, doctors and rural health care." International Journal of Nursing Practice 6, no. 6 (December 2000): 283. http://dx.doi.org/10.1046/j.1440-172x.2000.00278.x.

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23

MIFLIN, BARBARA, and DAVID PRICE. "Rural doctors are naturally effective teachers." Australian Journal of Rural Health 2, no. 1 (November 1993): 21–28. http://dx.doi.org/10.1111/j.1440-1584.1993.tb00094.x.

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National Rural Health Alliance. "Of rural doctors, bubbles and rainbows." Australian Journal of Rural Health 19, no. 4 (July 20, 2011): 225. http://dx.doi.org/10.1111/j.1440-1584.2011.01215.x.

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Subrahmanian, Prasanth, Shivangi Rai, and Himanshu Bhushan. "Making doctors available for rural India:." Revista de Direito Sanitário 20, no. 2 (May 12, 2020): 196–217. http://dx.doi.org/10.11606/issn.2316-9044.v20i2p196-217.

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In the backdrop of acute shortage of allopathic doctors in rural India, this paper looks at the interplay and tension between central and state regulatory measures aimed at improving the availability and retention of allopathic doctors in the rural areas, within the overarching framework of centre-state relations and division of legislative powers between them, with respect to regulation of medical education. While the Central Government has introduced certain provisions in the central law to promote availability of doctors in rural areas, some States have implemented provisions with the same objective, that go beyond the stipulations of the Central Act. Several such measures taken by state governments; be it reservation of post graduate seats for doctors serving in government rural institutions or developing cadre of medical practitioners for rural area under certain conditionalities; have been challenged in courts and held to be violative of the central legislation which inter alia, regulates standards of medical education and registration of doctors. The measures introduced by the state governments for increasing availability of doctors in rural areas, even though struck down as invalid, were intended as instruments of equity and social justice, with far reaching implications for improving availability of health care services in underserved areas. Unless the Medical Council of India Act is amended or the subject matter of medical education is moved from Union list to State list, state interventions are likely to continue to be struck down if they are found to be affecting the standards of medical education.

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Reynolds, Toby. "Australia runs short of rural doctors." BMJ 332, Suppl S1 (January 1, 2006): 06015. http://dx.doi.org/10.1136/sbmj.06015.

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Gupta, Shallini, Kanika Khajuria, Vijay Khajuria, and Niraj Kumar. "Comparative study of impact of marketing strategies of pharmaceutical houses on prescription practices of doctors rural vs urban." International Journal of Basic & Clinical Pharmacology 7, no. 5 (April 23, 2018): 1016. http://dx.doi.org/10.18203/2319-2003.ijbcp20181653.

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Background: Indian pharmaceutical market is fast going and there is a stiff competition amongst them as single product is marketed by different brand names. The pharmaceutical houses adopt different strategies to influence the physician to promote their products. These strategies are known to influence the prescription behaviour of physician, which may have variable impact among rural and urban doctors. Aim of the study was to compare the impact of marketing strategies of pharmaceutical houses on prescription practices of rural and urban doctors.Methods: The current crossover study was conducted among urban and rural doctors. A questionnaire consisting of 17 questions was presented to the doctors and their responses regarding different aspects of marketing strategies was recorded. Comparison between two groups was done using unpaired t-test.Results: Different strategies had impact on prescription pattern of doctors working in rural and urban institutions. All 17 parameters were affected similarly except e-mailing where urban doctors were more influenced (p=0.005).Conclusions: Present study indicates marketing strategies by different pharmaceutical houses do influence prescription pattern of physicians. Both urban and rural doctors were similarly affected except e- mailing which had more impact on urban doctors.

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Lu, Yingjie, and Qian Wang. "Doctors’ Preferences in the Selection of Patients in Online Medical Consultations: An Empirical Study with Doctor–Patient Consultation Data." Healthcare 10, no. 8 (July 30, 2022): 1435. http://dx.doi.org/10.3390/healthcare10081435.

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Online medical consultation (OMC) allows doctors and patients to communicate with each other in an online synchronous or asynchronous setting. Unlike face-to-face consultations in which doctors are only passively chosen by patients with appointments, doctors engaging in voluntary online consultation have the option of choosing patients they hope to treat when faced with a large number of online questions from patients. It is necessary to characterize doctors’ preferences for patient selection in OMC, which can contribute to their more active participation in OMC services. We proposed to exploit a bipartite graph to describe the doctor–patient interaction and use an exponential random graph model (ERGM) to analyze the doctors’ preferences for patient selection. A total of 1404 doctor–patient consultation data retrieved from an online medical platform in China were used for empirical analysis. It was found that first, mildly ill patients will be prioritized by doctors, but the doctors with more professional experience may be more likely to prefer more severely ill patients. Second, doctors appear to be more willing to provide consultation services to patients from urban areas, but the doctors with more professional experience or from higher-quality hospitals give higher priority to patients from rural and medically underserved areas. Finally, doctors generally prefer asynchronous communication methods such as picture/text consultation, while the doctors with more professional experience may be more willing to communicate with patients via synchronous communication methods, such as voice consultation or video consultation.

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Mukherjee, Abhijit, Ranadip Chowdhury, and Somnath Naskar. "Why are medical graduates not joining the rural services in India." Journal of Comprehensive Health 5, no. 2 (December 31, 2017): 72–73. http://dx.doi.org/10.53553/jch.v05i02.011.

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There are significant differences in the health parameters between the urban and rural areas of India. While most parameters have reached levels comparable to the developed world in the metropolises, they remain significantly lower in the rural areas of the country. One of the major reasons for this difference is the insufficient deployment of human resources, especially doctors in the health institutions located in rural areas. Physicians are reluctant to take up jobs in rural locations. The government of India estimated in 2010 a short-fall of 10.3% for doctors at primary health centers (PHCs) and 62% for specialists at the secondary level1. The doctor: population ratio is 13: 10000 in the urban areas but only 3: 10000 in the rural areas of the country.2Joining in and adhering to rural health services are often defined by the availability of benefits like financial incentives in the form of loan repayment and scholarships for students willing to serve in rural areas, as in the United States. Monetary incentives along with professional development opportunities are also used for recruiting and retaining physicians to rural areas in several other countries. The government of India provides incentives such as the rural or hardship allowance and reservation of post graduate seats for physicians serving in the rural areas. However, these are not considered enough motivation by the vast majority of medical graduates in India, who take up jobs in city based hospitals, sometimes for lesser remunerations. Professional isolation and lack of infrastructural facilities, less salary, low standard of living and limited exposure as a doctor continue to discourage physicians from joining rural service. This trend is not unique to India and reluctance of medical graduates to set up rural practice or join rural health services have been in seen in countries both from the developing as well as the developed worlds.

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Laveaga, Gabriela Soto. "Bringing the Revolution to Medical Schools." Mexican Studies/Estudios Mexicanos 29, no. 2 (2013): 397–427. http://dx.doi.org/10.1525/msem.2013.29.2.397.

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This article explores the establishment of the 1936 Social Service requirement for medical students and the creation of a major in Rural Health at the Instituto Politécnico Nacional in Mexico City to explain how health and physicians became an extension of the aims of the Mexican Revolution. The author argues that the 1930s attempt to bring doctors to rural areas had a two-fold intent that went beyond health and a geographic distribution of doctors: first, socialize mainly urban doctors to care for the rural poor and, second, create agents of the state in difficult to access marginal areas. Este artículo analiza el establecimiento del requisito de Servicio Social para los estudiantes de medicina en 1936 y la creación de una Licenciatura en Salud Rural en el Instituto Politécnico Nacional de la ciudad de México para explicar de qué manera la salud y los médicos se convirtieron en una extensión de los objetivos de la Revolución mexicana. El autor sostiene que el intento de llevar médicos a las zonas rurales durante la década de los treinta tenía una doble intención más allá de la salud y la distribución geográfica de los galenos: en primer lugar, socializar a los doctores, mayoritariamente urbanos, para atender a los enfermos rurales y, en segundo lugar, crear agentes del estado en zonas marginales de difícil acceso.

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Agboatwalla, M., G. N. Kazi, S. K. Shah, and M. Tariq. "Gender perspectives on knowledge and practices regarding tuberculosis in urban and rural areas in Pakistan." Eastern Mediterranean Health Journal 9, no. 4 (September 21, 2003): 732–40. http://dx.doi.org/10.26719/2003.9.4.732.

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We investigated gender differences in knowledge of and attitude towards tuberculosis [TB] in urban and rural communities in Sindh province, Pakistan. Knowledge of symptoms was generally deficient, particularly in rural females. Regarding TB prevention, 22.4% of rural and 14.4% of urban males said completing treatment was important; only 9.8% of rural and 7.1% of urban females agreed. Doctors were an important source of information in rural areas and 60.9% of rural males said they would only stop treatment on a doctor’s advice. In contrast, > 65% of respondents in urban areas said they would stop treatment when symptoms ended. Our study highlights the need to increase population awareness about TB in Sindh

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Kamalakanthan, Abhaya, and Sukhan Jackson. "Doctor supply in Australia: rural - urban imbalances and regulated supply." Australian Journal of Primary Health 15, no. 1 (2009): 3. http://dx.doi.org/10.1071/py08055.

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We review the debate on the supply of doctors in Australia from an economic perspective. We focus on the supply between urban and rural areas and on Australia’s reliance on foreign-born overseas-trained doctors. Documented evidence shows that doctors are concentrated in cities and rural Australians have relatively poor access; and there is heavy reliance on the recruitment of foreign doctors. We suggest that besides training more local doctors, policy-making should include innovations to resolve the supply imbalance such as physician assistants and community pharmacy care in areas where access to general practitioners is often limited.

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Shanmugapriya, J. "Existential, Relatedness, Growth (ERG) needs’ dimensions of medical students for rural posting – An analytical study." Turkish Journal of Computer and Mathematics Education (TURCOMAT) 12, no. 3 (April 11, 2021): 3310–17. http://dx.doi.org/10.17762/turcomat.v12i3.1585.

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The retention of rural doctors in India is a very big challenge. Despite the mandatory rural postings, year by year rural health statistics indicate an abysmal picture of rural doctors' vacancies and their shortfalls in many states. Various studies stipulate that rural doctors are quitting rural postings. A reliable instrument to identify the motivational needs of doctors towards their rural postings, suitable to the Indian context, which is vital for both policymakers and doctors alike. So, this study aims to acquire the reliability of the Existential, relatedness, and Growth needs of Doctors’ questionnaire and to obtain the dimensions of needs as an initial attempt. An ERG motivational need questionnaire was developed to explain the needs of medical graduates and rurally placed physicians in Indian context. A literature search and pilot study with 64 medical students conducted and relevant items were extracted. This study was conducted in Jaipur, Chennai, and Pondicherry. The reduction of items was done through principal component analysis in SPSS. Cronbach Alpha coefficient is considered to measure for internal consistency reliability of the instrument. The instrument is developed with three constructs namely Existential needs (EN), Relatedness Needs (RN), and Growth Needs (GN) with a 5-point Likert scale. The exploratory factor analysis after three rotations converged to 9 factors with 74.103 total variance and 0.606 Kaiser-Meyer- Olkin index indicating sampling adequacy. The initial scale items (with 58 Items) were reduced to 9 factors with 28 items in the final questionnaire. Overall scale is with Cronbach alpha value of 0.851 for these items. The result obtained has proven that the extracted 9 factors have good reliability to obtain the dimensions of Existential, relatedness, and growth needs. The study results have implications in addressing the problem of Rural doctors’ shortage.

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Playford, Denese, Hanh Ngo, David Atkinson, and Ian B. Puddey. "Graduate doctors’ rural work increases over time." Medical Teacher 41, no. 9 (June 10, 2019): 1073–80. http://dx.doi.org/10.1080/0142159x.2019.1621278.

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Ricketts, Thomas C., L. Gary Hart, and Michael Pirani. "How Many Rural Doctors Do We Have?" Journal of Rural Health 16, no. 3 (June 2000): 198–207. http://dx.doi.org/10.1111/j.1748-0361.2000.tb00457.x.

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Woloschuk, Wayne, Ron Gorsche, and Michael Betzner. "General emergency medicine skills for rural doctors." Medical Education 40, no. 11 (November 2006): 1142–43. http://dx.doi.org/10.1111/j.1365-2929.2006.02584.x.

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Pryor, Hon David. "Solutions to the Shortage of Rural Doctors." Journal of Aging & Social Policy 4, no. 3-4 (February 26, 1993): 13–15. http://dx.doi.org/10.1300/j031v04n03_03.

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Hain, S., A. Tomita, P. Milligan, and B. Chiliza. "Retain rural doctors: Burnout, depression and anxiety in medical doctors working in rural KwaZulu-Natal Province, South Africa." South African Medical Journal 111, no. 12 (December 2, 2021): 1197. http://dx.doi.org/10.7196/samj.2021.v111i12.15841.

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Matsumoto, Masatoshi, Masanobu Okayama, Kazuo Inoue, and Eiji Kajii. "Factors associated with rural doctors' intention to continue a rural career: A survey of 3072 doctors in Japan." Australian Journal of Rural Health 13, no. 4 (August 2005): 219–25. http://dx.doi.org/10.1111/j.1440-1584.2005.00705.x.

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Pandit, Tarsh, Robin A. Ray, and Sabe Sabesan. "Managing Emergencies in Rural North Queensland: The Feasibility of Teletraining." International Journal of Telemedicine and Applications 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/8421346.

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Introduction. Historically, the use of videoconference technologies in emergency medicine training has been limited. Whilst there are anecdotal reports of the use of teletraining for emergency medicine by rural doctors in Australia, minimal evidence exists in the literature. This paper aimed to explore the use of teletraining in the context of managing emergency presentations in rural hospitals. Methods. Using a qualitative approach, a mixture of junior and senior doctors were invited to participate in semistructured interviews. Data were transcribed and analysed line by line. Applying the grounded theory principles of open and axial coding, themes and subthemes were generated. Results. A total of 20 interviews were conducted with rural doctors, rural doctors who are medical educators, and emergency medicine specialists. Two major themes—(1) teletraining as education and (2) personal considerations—and ten subthemes were evident from the data. Most participants had some previous experience with teletraining. Access to peer teaching over videoconference was requested by rural generalist registrars. There was a preference for interactive training sessions, over didactic lectures with little mention of technical barriers to engagement. The ability of teletraining to reduce professional isolation was a major benefit for doctors practicing in remote locations. Discussion. For these rural doctors, teletraining is a feasible method of education delivery. Wider application of teletraining such as its use in peer teaching needs to be explored. The benefits of teletraining suggest that teletraining models need to be core business for health services and training providers, including specialist colleges.

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Yadav, Uday Narayan, Jane Lloyd, Hassan Hosseinzadeh, Kedar Prasad Baral, Sagar Dahal, Narendra Bhatta, and Mark Fort Harris. "Facilitators and barriers to the self-management of COPD: a qualitative study from rural Nepal." BMJ Open 10, no. 3 (March 2020): e035700. http://dx.doi.org/10.1136/bmjopen-2019-035700.

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ObjectiveTo understand the facilitators and barriers to the self-management of chronic obstructive pulmonary disease (COPD) in rural Nepal.SettingsCommunity and primary care centres in rural Nepal.ParticipantsA total of 14 participants (10 people with COPD and 4 health care providers) were interviewed.Primary and secondary outcome measure(s)People with COPD and healthcare provider’s experience of COPD self-management in rural Nepal.ResultsFacilitators and barriers affecting COPD self-management in Nepal operated at the patient-family, community and service provider levels. People with COPD were found to have a limited understanding of COPD and medications. Some participants reported receiving inadequate family support and described poor emotional health. At the community level, widespread use of complementary and alternative treatment was found to be driven by social networks and was used instead of western medicine. There were limited quality controls in place to monitor the safe use of alternative treatment. While a number of service level factors were identified by all participants, the pertinent concerns were the levels of trust and respect between doctors and their patients. Service level factors included patients’ demands for doctor time and attention, limited confidence of people with COPD in communicating confidently and openly with their doctor, limited skills and expertise of the doctors in promoting behavioural change, frustration with doctors prescribing too many medicines and the length of time to diagnose the disease. These service level factors were underpinned by resource constraints operating in rural areas. These included inadequate infrastructure and resources, limited skills of primary level providers and lack of educational materials for COPD.ConclusionsThe study findings suggest the need for a more integrated model of care with multiple strategies targeting all three levels in order to improve the self-management practices among people with COPD.

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Sun, Yingxian, Zhao Li, Xiaofan Guo, Ying Zhou, Nanxiang Ouyang, Liying Xing, Guozhe Sun, et al. "Rationale and Design of a Cluster Randomized Trial of a Village Doctor-Led Intervention on Hypertension Control in China." American Journal of Hypertension 34, no. 8 (February 19, 2021): 831–39. http://dx.doi.org/10.1093/ajh/hpab038.

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Abstract BACKGROUND In China, hypertension prevalence is high and increasing while the control rate is low, especially in rural areas. Traditionally, village doctors play an important role in infectious disease control and delivering essential health services to rural residents. We aim to test the effectiveness of a village doctor-led multifaceted intervention compared with usual care on blood pressure (BP) control and cardiovascular disease (CVD) among rural residents with hypertension in China. METHODS In the China Rural Hypertension Control Project (CRHCP), a cluster randomized trial, 163 villages were randomly assigned to the village doctor-led intervention and 163 villages to control. A total of 33,995 individuals aged ≥40 years with an untreated BP ≥140/90 mm Hg or treated BP ≥130/80 mm Hg or with an untreated BP ≥130/80 mm Hg and a history of clinical CVD were recruited into the study. The village doctor-led multifaceted intervention is designed to overcome barriers at the healthcare system, provider, patient, and community levels. Village doctors receive training on standard BP measurement, protocol-based hypertension treatment, and health coaching. They also receive technical support and supervision from hypertension specialists/primary care physicians and performance-based financial incentives. Study participants receive health coaching on home BP monitoring, lifestyle changes, and adherence to medications. The primary outcome is BP control (<130/80 mm Hg) at 18 months in phase 1 and CVD events over 36 months in phase 2. CONCLUSIONS The CRHCP will provide critically important data on the effectiveness, implementation, and sustainability of a hypertension control strategy in rural China for reducing the BP-related CVD burden. CLINICAL TRIALS REGISTRATION Trial Number NCT03527719.

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Xue, Hao, Yaojiang Shi, and Alexis Medina. "Who are rural China’s village clinicians?" China Agricultural Economic Review 8, no. 4 (November 7, 2016): 662–76. http://dx.doi.org/10.1108/caer-12-2015-0181.

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Purpose The purpose of this paper is to measure the turnover (or stability in employment) of village clinicians in rural China over the past decade. The authors also want to provide quantitative evidence on the individual characteristics of the clinicians who provide health care to villagers in rural China and whether we should expect these individuals to be interested in continuing to supply quality health care in China’s villages in the coming years. Design/methodology/approach This paper uses data from a survey of rural China’s village clinicians conducted in five provinces, 25 counties, and 101 villages in 2005 and 2012. This paper also uses qualitative data from interviews with 31 village clinicians. Using a mixed methods approach, this study describes the turnover of village clinicians and the main factors that impact the career decisions of clinicians. Findings Turnover of China’s village doctors, while not trivial (about 25 percent of village doctors exited their field between 2005 and 2012), is still not overly high. Only five out of 101 villages did not have village clinicians in 2012. Of those that lost village doctors between 2005 and 2012, nearly all of them still had a village doctor in 2012 (either taken over by another local clinician or the position was taken by a newcomer). The authors find that three main sets of factors are correlated with the career decisions of village clinicians: village clinicians’ opportunity cost, the profitability of running a village clinic, and commitment to the field of medicine. In general, clinicians who left the village faced a much higher opportunity cost, had been running a clinic that was not profitable, and had fewer ties to the field of medicine. Newcomers over the same period had higher levels of education, went to higher profit clinics between 2005 and 2012, and had a stronger commitment to the field. Originality/value This study makes use of a data set with a large and nationally representative sample to provide a new perspective to better understand clinician turnover at village clinics, the career decisions of clinicians, and the implied trends for the quality and access to rural health care services in the future.

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Silveira, Cedric Thomas. "IMPACT OF MEDICAL REPRESENTATIVES ON ACCEPTANCE OF HIGH PRICED PRESCRIPTION DRUGS BY DOCTORS: A STUDY." International Journal of Research -GRANTHAALAYAH 9, no. 11 (December 9, 2021): 227–34. http://dx.doi.org/10.29121/granthaalayah.v9.i11.2021.4348.

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Do rapport and information have any bearing on doctors’ preference for high priced products? This was the study undertaken by me. Doctors in urban areas usually do not have the time to develop rapport with the medical representatives and as a result should not accept high priced products. On the other hand information too will not influence prescription of high priced products because they depend upon peer advice, seminars and conferences and evaluation tests. The situation among rural doctors is different wherein they should welcome medical representatives and their information and develop a rapport with them and thereby prescribe high priced products. However it was seen that developing a rapport was not enough for rural doctors to prescribe high priced products as they looked into the affordability of their patients first. However information was accepted and even high priced products were prescribed by doctors. On the other hand urban doctors were not influenced by either rapport or information and depended on conferences, seminars, peer advice and evaluation tests before prescribing high priced products. The study was conducted on 200 urban doctors and 200 rural doctors in Goa. A personal interview was conducted wherein the questionnaire was direct and structured. Pearson’s coefficient of correlation was used to determine if information and rapport had any correlation with doctors prescribing high priced products.

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Gurung, Milan, and Arvind Saraswat. "Satisfaction of Patients from the Quality Service of Diagnosis of Health Problem in Public Health Institutions of Nepal." Nepal Journal of Multidisciplinary Research 2, no. 3 (December 31, 2019): 33–38. http://dx.doi.org/10.3126/njmr.v2i3.26973.

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Health should be the first priority of each people; people can do creative work if s/he is healthy. According to the annual report of the Department of Health Services (DoHS) for fiscal year 2072/73 (2015/2016), the main institutions that delivered basic health services were 104 public hospitals, 303 private hospitals, 202 primary health care centres (PHCCs) and 3,803 health posts. The primary health care services also provided 12,660 primary health care outreach clinic (PHCORC) sites. The health service was affected from the earthquake of April 2015 so the study aims to identify the satisfaction of patient from quality of diagnosis of health problem in public health institutions after earthquake. The study had covered 82 health institutions (45 from Kavre and 37 from Sindhupalchowak district). The statistical result of t-test shows that there was significant difference in approach of doctors (p = .012), and counselling of doctors (p=.043) but there was no difference in answering the queries promptly (p=.187), and explanation given for aliment (p = .180). The descriptive data show slight increase in level of satisfaction of patient after earthquake. Still health posts established in rural setting have inadequate human resource basically doctors are not adequate so Government should provide the trained Doctor in rural areas to increase the access of rural people in health services.

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Bariya, Bhaveshbhai Rameshbhai. "Rural Health Training centre Activities for Internee doctors â€“ A Real Time Exposure to Rural Community Health." Journal of Comprehensive Health 7, no. 1 (June 30, 2019): 47–48. http://dx.doi.org/10.53553/jch.v07i01.012.

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Internship is a phase of training wherein a medical graduate is expected to conduct actual practice of medical and health care and acquire skills under supervision so that he/she may become capable of functioning independently. It was a recommendation of Bhore Committee that there should be three months training of medical undergraduates in preventive and social medicine to prepare â€œsocial physiciansâ€ during their internship training.(1)There is two months training for internee doctors in community medicine; one month in Rural Health Training centre and urban health training centre each. The focus of this training duration is to orient the internee doctors at community located either at rural or urban area, so that they can be prepared of dealing with community at large after successful completion of internship. This article is an attempt to help the officials to plan or direct the internee doctors for various activities in field during their posting in community medicine department.

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Maley, Moira A., Vanessa L. Lockyer-Stevens, and Denese E. Playford. "Growing rural doctors as teachers: A rural community of medical education practice." Medical Teacher 32, no. 12 (September 27, 2010): 983–89. http://dx.doi.org/10.3109/0142159x.2010.509421.

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Eley, Diann, Louise Young, and Marilyn Shrapnel. "Rural temperament and character: A new perspective on retention of rural doctors." Australian Journal of Rural Health 16, no. 1 (January 7, 2008): 12–22. http://dx.doi.org/10.1111/j.1440-1584.2007.00946.x.

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Juraeva, Nargis S., Martin W. Bratschi, Kaspar Wyss, and Ismoil S. Komilov. "Work Time Allocation of Family Doctors in Rural Tajikistan." International Journal of Applied Research in Bioinformatics 10, no. 2 (July 2020): 28–37. http://dx.doi.org/10.4018/ijarb.2020070104.

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There is a little-known study about how family doctors actually use their working time providing patient care, administration, and other activities. This paper investigates this issue for family doctors who are working in health facilities of a rural area in Tajikistan. To capture information about time allocation, 24 family doctors were observed during conventional working hours by observers for five days each over a period of four weeks. Data collection was conducted in the four randomly selected districts in rural Tajikistan in 2015. Results were presented in terms of percentage of time allocation for direct patient treatment, documentation activities, continuous medical education, health promotion, traveling and walking, and for unproductive time. Time allocation was also compared between family doctors working at the polyclinics and at the rural health centers. The data collected can be used for future decision making and as a baseline to assess the impact of further reforms in the healthcare system of Tajikistan.

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Shulman, Neil, and Daniel Appelrouth. "Request for Ideas to Humanize Physicians." Pediatrics 93, no. 5 (May 1, 1994): 869. http://dx.doi.org/10.1542/peds.93.5.869.

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As the author of the book Doc Hollywood, I tried to make some impact on an important health care issue relating to the shortage of doctors in rural areas. By developing a story about a doctor who gets stuck in a small rural town during a cross-country automobile trip to Hollywood, I attempted to show the benefits of family practice in an area of need. Now I am joining a colleague in an effort to develop a nonfiction book on another medical topic that is close to my heart.

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