117 lines
3.7 KiB
YAML
117 lines
3.7 KiB
YAML
abstract: 'Context The US government is expanding the capacity of community health
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centers (CHCs) to provide care to underserved populations.
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Objective To examine the status of workforce shortages that may limit
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CHC expansion.
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Design and Setting Survey questionnaire of all 846 federally funded US
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CHCs that directly provide clinical services and are within the 50
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states and the District of Columbia, conducted between May and September
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2004. Questionnaires were completed by the chief executive officer of
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each grantee. Information was supplemented by data from the 2003 Bureau
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of Primary Health Care Uniform Data System and weighted to be nationally
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representative.
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Main Outcome Measures Staffing patterns and vacancies for major clinical
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disciplines by rural and urban location, use of federal and state
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recruitment programs, and perceived barriers to recruitment.
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Results Overall response rate was 79.3\%. Primary care physicians made
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up 89.4\% of physicians working in the CHCs, the majority of whom are
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family physicians. In rural CHCs, 46\% of the direct clinical providers
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of care were nonphysician clinicians compared with 38.9\% in urban CHCs.
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There were 428 vacant funded full-time equivalents (FTEs) for family
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physicians and 376 vacant FTEs for registered nurses. There were
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vacancies for 13.3\% of family physician positions, 20.8\% of
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obstetrician/ gynecologist positions, and 22.6\% of psychiatrist
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positions. Rural CHCs had a higher proportion of vacancies and
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longer-term vacancies and reported greater difficulty filling positions
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compared with urban CHCs. Physician recruitment in CHCs was heavily
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dependent on National Health Service Corps scholarships, loan repayment
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programs, and international medical graduates with J-1 visa waivers.
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Major perceived barriers to recruitment included low salaries and, in
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rural CHCs, cultural isolation, poor-quality schools and housing, and
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lack of spousal job opportunities.
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Conclusions CHCs face substantial challenges in recruitment of clinical
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staff, particularly in rural areas. The largest numbers of unfilled
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positions were for family physicians at a time of declining interest in
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family medicine among graduating US medical students. The success of the
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current US national policy to expand CHCs may be challenged by these
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workforce issues.'
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affiliation: 'Rosenblatt, RA (Corresponding Author), Univ Washington, Dept Family
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Med, Rural Hlth Res Ctr, Box 354696, Seattle, WA 98195 USA.
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Univ Washington, Dept Family Med, Rural Hlth Res Ctr, Seattle, WA 98195 USA.
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Natl Assoc Community Hlth Ctr, Bethesda, MD USA.'
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author: Rosenblatt, RA and Andrilla, CHA and Curtin, T and Hart, LG
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author-email: rosenb@u.washington.edu
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author_list:
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- family: Rosenblatt
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given: RA
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- family: Andrilla
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given: CHA
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- family: Curtin
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given: T
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- family: Hart
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given: LG
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da: '2023-09-28'
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doi: 10.1001/jama.295.9.1042
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eissn: 1538-3598
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files: []
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issn: 0098-7484
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journal: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
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keywords-plus: 'PHYSICIAN WORKFORCE; FAMILY PHYSICIANS; SERVICE-CORPS; FOLLOW-UP;
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CARE;
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AREAS; RETENTION; URBAN; RECRUITMENT; EXPERIENCE'
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language: English
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month: MAR 1
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number: '9'
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number-of-cited-references: '61'
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pages: 1042-1049
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papis_id: cef0d602941975eb78cca77b9226d44d
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ref: Rosenblatt2006shortagesmedical
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researcherid-numbers: Andrilla, Holly/AAC-6264-2019
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times-cited: '218'
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title: Shortages of medical personnel at community health centers - Implications for
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planned expansion
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type: Article
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unique-id: WOS:000235656600024
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usage-count-last-180-days: '0'
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usage-count-since-2013: '27'
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volume: '295'
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web-of-science-categories: Medicine, General \& Internal
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year: '2006'
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