The impact of pecuniary and non-pecuniary incentives for attracting young doctors to rural general practice

• Published in: Social science & medicine (1982) Vol. 128; pp. 1 - 9
• Main Authors: Holte, Jon Helgheim, Kjaer, Trine, Abelsen, Birgit, Olsen, Jan Abel
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.03.2015; Pergamon Press Inc
• Subjects: Adult; Attitude of Health Personnel; Bayes Theorem; Career Choice; Career Mobility; Choice Behavior; Data collection; Discrete choice experiments; Doctors; Family Practice - economics; Family Practice - manpower; Female; General practice; Humans; Impact analysis; Incentives; Income; Interviews as Topic; Job Satisfaction; Male; Models, Econometric; Motivation; Norway; Personnel Loyalty; Physicians; Physicians - supply & distribution; Professional Practice Location; Qualitative Research; Reference dependence; Rural; Rural areas; Rural Health Services - economics; Rural Health Services - manpower; Work Schedule Tolerance; Young doctors; Youth; Norway; Rural; Reference dependence; Incentives; Discrete choice experiments; Norway; Young doctors; General practice
• ISSN: 0277-9536; 1873-5347; 1873-5347
• DOI: 10.1016/j.socscimed.2014.12.022

Shortages of GPs in rural areas constitute a profound health policy issue worldwide. The evidence for the effectiveness of various incentives schemes, which can be specifically implemented to boost recruitment to rural general practice, is generally considered to be poor. This paper investigates young doctors' preferences for key job attributes in general practice (GP), particularly concerning location and income, using a discrete choice experiment (DCE). The subjects were all final year medical students and interns in Norway (N = 1562), of which 831 (53%) agreed to participate in the DCE. Data was collected in November–December 2010. Policy simulations were conducted to assess the potential impact of various initiatives that can be used to attract young doctors to rural areas. Most interestingly, the simulations highlight the need to consider joint policy programs containing several incentives if the policies are to have a sufficient impact on the motivation and likelihood to work in rural areas. Furthermore, we find that increased income seem to have less impact as compared to improvements in the non-pecuniary attributes. Our results should be of interest to policy makers in countries with publicly financed GP systems that may struggle with the recruitment of GPs in rural areas. •Shortages of GPs in rural areas constitute a profound health policy problem worldwide.•Our aim is to identify incentives that can boost recruitment of GPs to rural areas.•Non-pecuniary incentives appear to have stronger effect than financial incentives.•Joint policy programs containing several incentives are required to boost recruitment.