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Physician satisfaction and practice intentions in Northwestern Ontario.

OBJECTIVE
The goal of this research was to understand factors that affect future practice intentions of physicians who practise in rural and underserviced areas. The following 2 research questions are answered: "How many physicians in Northwestern Ontario intend to leave their practice in 5 years?" and "What is the association between professional, personal/family and community factors in physician satisfaction and intention to stay in practice?"


METHODS
Between September and October 2004, physicians practising in Northwestern Ontario were mailed a survey measuring professional, personal/family and community satisfaction as well as future practice intentions. Future practice intention (question 1) was analyzed through a frequency distribution, while the factors that influenced intention (question 2) were analyzed using a 3-step process: a factor analysis, the creation of scales and a logistic regression. The themes of the scales emerging from the factor analysis were family/community, time, professional support and efficacy, and sense of belonging and appreciation. The means of these 4 scales were entered into a logistic regression model along with demographic variables that were independent predictors of future practice intention.


RESULTS
Three hundred and twenty-eight physicians were sent the survey. After 3 consecutive mailings, the response rate was 61.3% (n=201). Over two-thirds of Northwestern Ontario physicians intended to remain in practice in 5 years; however, most of these physicians were from Thunder Bay, the only city (100 000+ population) in Northwestern Ontario. Physicians were significantly more likely to intend to stay in practice if they were younger, practised in Thunder Bay and scored higher on the family/community scale.


CONCLUSION
These findings underscore the importance of addressing family and community factors, as opposed to strictly professional factors, in future retention initiatives.