Practice location preferences among General Practitioners. A literature review and a statistical analysis highlighting associated factors and characteristics

Abstract

Abstract The objective of this study is to investigate the GPs preferences in practice location, whether actions have been taken to improve the recruitment and retention of GPs in small municipalities, and if there are any specific characteristics of the GPs that are associated with their preference in practice location. A literature review of relevant material and a statistical analysis of prospective GPs and currently practicing GPs’ characteristics have been performed. The statistical analyses found, that for groups the least preferred practice location were municipalities with less than 5000 inhabitants. Several of the independent variables were significantly associated with the GPs and prospective GPs preference in practice location. The strongest predictors for preferred practice location were the variables current practice location (p<0.001), number of inhabitants in home municipality (p=0.001) and location of medical training (p=0.003). These results are concurrent to findings from the literature review. The literature review furthermore highlights certain initiatives where these predictors have been in focus, namely decentralizing medical schools, reimbursement and scholarships against mandatory rural practice, and targeting students who originate from small municipalities. Professional isolation, a heavier workload, and receiving more patients in small municipalities are some of the factors mentioned in the literature review for why GPs prefer practicing in larger municipalities. The GPs’ preference for rural practice is related to having a relation to a small municipality. Hence, initiatives with the aim of creating or strengthening the bonds between prospective GPs as well as currently practicing GPs and remote practice locations are essential to improve the preference for rural practice.