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What Is the Impact on Rural Area Residents When the Local Physician Leaves?

机译：当地医师叶时，农村居民对农村居民的影响是什么？

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Background and Objectives: Scarce evidence exists in the medical literature describing the attitudes of rural community residents about the impact of losing their local physician. This pilot study explores aspects of access to care, both within and outside of primary care settings, that result from loss of a rural family physician. Methods: We selected study participants through convenience and snowball sampling, and we conducted in-person interviews of up to 60 minutes. We audio recorded and transcribed the interviews (May to August, 2018), then analyzed transcripts using immersion crystallization and managed within Atlas.ti 7.0 software (Berlin, Germany). Results: We interviewed 18 participants, some of whom interviewed as pairs. Our analysis revealed three significant themes: rurally-specific access to care concerns, relationships valued for being both community and care based, and loss felt specific to the integrated community leadership roles occupied by family physicians. In addition, participants identified social challenges they associated with losing their “country doctor,” such as withering community cohesion. Conclusions: Our findings suggest that rural physicians offer tremendous value to their communities, both inside and beyond their clinic walls. Issues of social cohesion and local health leadership affected by physician loss should be addressed by policy makers and educators charged with designing patient-centered solutions to improve health outcomes in rural communities. Current health and medical education reforms would benefit from greater focused attention on these issues.
机译：背景和目标：医学文献中存在稀缺的证据，描述农村社区居民关于失去当地医师的影响的态度。这项试点研究探讨了初级保健环境内外的护理的各个方面，这是由于农村家庭医生的损失而导致的。方法：我们通过便利和雪球采样选择了学习参与者，我们在众多接受持续60分钟的访谈中进行。我们通过录制和转录访谈（5月至2018年8月），然后使用浸入式结晶和在Atlas.ti 7.0软件（柏林，德国）内进行分析的转录物。结果：我们采访了18名参与者，其中一些人面试成对。我们的分析揭示了三个重要主题：针对社区和关怀的统治性关注，估值的关系，以及家庭医生占领的综合社区领导作用的关系。此外，与会者还确定了与失去“国家医生”相关的社会挑战，例如遇到社区凝聚力。结论：我们的研究结果表明，农村医生对其诊所墙壁的社区提供巨大价值。由医生损失影响的社会凝聚力和当地健康领导的问题应由决策者和教育工作者负责设计患者以患者为中心的解决方案来改善农村社区的健康成果。当前的健康和医学教育改革将从更多的重点关注这些问题中受益。

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