Factors Influencing the Decision to Practice Medicine in West Virginia: Findings from a Statewide Survey of Physicians

Abstract

Introduction The purpose of the study was to identify factors that influence the decision to practice medicine in West Virginia (WV) and to identify state-specific targets to address workforce issues. Methods A cross-sectional study was conducted between November 2019 and March 2020 using an online link to an anonymous survey sent to all physicians with a e-mail address on file with the state allopathic medical licensing board and the WV Osteopathic Medical Association. Descriptive statistics and inductive analyses were employed. Results Forty-five percent of respondents were from WV, and 17% were from rural WV in the sample size of 428. Quality of life and loan forgiveness/repayment were more important to primary care than specialty care providers. Community attributes were important to native West Virginians. Recruitment and retention themes that emerged were as follows: home and family, the capacity to dually serve as faculty and clinician, to serve where most needed, debt payback, and quality of life. Discussion Quality of life and community attributes were the most influential factors in deciding to practice medicine in WV. Financial incentives were effective recruitment tools. Retention was strongly influenced by social and reimbursement policy in the state, clinical leadership at the local level, and lifestyle factors in the geographic region. Conclusion Enhancing relationships and coordinating programs across sectors to provide targeted recruitment, addressing socioeconomic and public health issues, and periodically evaluating physician satisfaction may be leverage points for physician recruitment and retention in WV.