Rural Women Family Physicians: Strategies for Successful Work-Life Balance

Dear Editor:

We just completed orientation for the Rural Medical Education (RMED) Program class of 2020, accepted to the University of Illinois College of Medicine at Rockford. Interestingly, the class of 30 RMED students is equally divided between women and men. The recent article 'Rural Women Family Physicians: Strategies for Successful Work-Life Balance' by Phillips et al. brought out many points as we look to the future of the women in this class in terms of rural healthcare delivery and retention in rural communities.

We know this was not a quantitative study and there are many questions about representativeness of the responding family physicians. From Illinois, where many women graduates have gone into rural family medicine as well as other specialties, there was one respondent. We are not sure that the emerging themes from the analysis were particularly striking or unexpected.

On the other hand, it is important to have a study like this for its implications for both policy and future research. In terms of the theme of support, a doable and significant strategy might be the observation that communities - not only families and hospitals/clinics - help provide available child care as well as general support for rural women physicians.

This study opens doors for future research. Questions we have, based on this work, include: 1) what is the retention rate, in years, of women physicians in rural areas? 2) how might results vary between rural women physicians going back to their home community versus those going into rural practice in a new community? 3) what is the impact of rural origin on perceptions of support and boundaries around work; and 4) are there differences in perceptions of rural women physicians related to provision of obstetric care? One issue we are interested in that was not addressed was women physicians' perceptions of addressing the mental health needs of women patients in rural communities. This could be another focus of future research.

Finally, a major issue in rural healthcare delivery is retention. Other work in this area has focused on overall burnout and satisfaction in creating a work-life balance for physicians (Shanafelt et al., 2012). How do the identified themes in the present study address retention outcomes of women physicians in rural areas? What is the impact of participating in pipeline health careers programs and recruitment and retention of women in rural medicine?

Overall, this was a very thought provoking article as we think about motivation, satisfaction, and future retention of women who will be graduating or have graduated from our program over the last 25 years of RMED.

Michael Glasser, PhD Dr. George T. and Mildred A. Mitchell Professor of Rural and Family Medicine Associate Dean for Rural Health Professions Director, National Center for Rural Health Professions

Hana Hinkle, MPH Assistant Director of Rural Health Workforce and Center Development National Center for Rural Health Professions

Reference

Shanafelt, T. D., Boone, S., Tan, L., Dyrbye, L. N., Sotile, W., Satele, D., Oreskovich, M. R. (2012). Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Archives of Internal Medicine, 172(18), 1377-1385.

Competing interests: None declared