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The purpose of this paper is to identify the challenges when recruiting and retaining rural physicians and to ascertain methods that make rural physician recruitment and retention successful. There are studies that suggest rural roots is an important factor in recruiting rural physicians, while others look at rural health exposure in medical school curricula, self-actualization, community sense and spousal perspectives in the decision to practice rural medicine.

An extensive literature review was performed using Academic Search Complete, PubMed and The Cochrane Collaboration. Key words were rural, rural health, community hospital(s), healthcare, physicians, recruitment, recruiting, retention, retaining, physician(s) and primary care physician(s). Inclusion criteria were peer-reviewed full-text articles written in English, published from 1997 and those limited to USA and Canada. Articles from foreign countries were excluded owing to their unique healthcare systems.

While there are numerous articles that call for special measures to recruit and retain physicians in rural areas, there is an overall dearth. This review identifies several articles that suggest recruitment and retention techniques. There is a need for a research agenda that includes valid, reliable and rigorous analysis regarding formulating and implementing these strategies.

Rural Americans are under-represented when it comes to healthcare and what research there is to assist recruitment and retention is difficult to find. This paper identify the relevant research and highlights key strategies.

France is a country that widely relies on a skilled labour force. Nevertheless, very little is written in the management literature on the career experiences of skilled migrants, in particular from developing countries, in France. This paper argues that in order to understand the management of skilled migrants in France, there is a need to better understand their career experiences. Therefore, the objective of this paper is to fill this knowledge gap by offering an enhanced understanding of the career experiences of Malagasy migrant physicians in France.

Based on the life story of 17 Malagasy migrant physicians and an interview with a Malagasy director of a private clinic who recruited Malagasy physicians to work in France, the paper sheds light on their career choices and challenges that they face in the French job market.

The results clearly highlight two career profiles: firstly, those who succeeded in working as physicians either directly upon their graduation, or throughout an “interstitial” career in nursing, a way to eventually reach their profession of physician. Second, findings show that there were participants who definitively switched to a nursing profession. For this second group, migration emerges as a challenging experience leading to talent waste and therefore to downward career mobility.

While literature on international careers frequently describe international mobility as being beneficial for skilled migrants, the findings yield limited support for this assumption. Instead, human capital was insufficient in explaining the career outcome of migrant physicians in France. Beyond the assumption that human capital is sufficient for undertaking a successful international experience, the paper contribute's to the literature on international careers by focusing on an under‐researched group (i.e. Malagasy physicians in France) and demonstrating the complex nature of their career experiences.

Healthcare policymakers and managers struggle to engage private physicians, who tend to view themselves as independent of the system, in new models of primary care. The purpose of this paper is to examine this issue through a social identity lens.

Through in-depth interviews with 33 decision-makers and 31 fee-for-service family physicians, supplemented by document review and participant observation, the authors studied a Canadian province’s early efforts to engage physicians in primary care renewal initiatives.

Recognizing that the existing physician–system relationship was generally distant, decision-makers invested effort in relationship-building. However, decision-makers’ rhetoric, as well as the design of their flagship initiative, evinced an attempt to proceed directly from interpersonal relationship-building to the establishment of formal intergroup partnership, with no intervening phase of supporting physicians’ group identity and empowering them to assume equal partnership. The invitation to partnership did not resonate with most physicians: many viewed it as an inauthentic offer from an out-group (“bureaucrats”) with discordant values; others interpreted partnership as a mere transactional exchange. Such perceptions posed barriers to physician participation in renewal activities.

The pursuit of a premature degree of intergroup closeness can be counterproductive, heightening physician resistance.

This study revealed that even a relatively subtle misalignment between a particular social identity management strategy and its intergroup context can have highly problematic ramifications. Findings advance the literature on social identity management and may facilitate the development of more effective engagement strategies.

The purpose of this paper is to present proposed solutions and interventions to some of the major barriers to providing adequate access to healthcare in Kenya. Specific business models are proposed to improve access to quality healthcare in low- and middle-income countries. Finally, strategies are developed for the retail clinic concept (RCC).

Google Scholar, PubMed and EBSCOhost were among the databases used to collect articles relevant to the purpose in Kenya. Various governmental and news articles were collected from Google searches. Relevant business models from other sectors were considered for potential application to healthcare and the retail clinic concept.

After a review of current methodologies and approaches to business and franchising models in various settings, the most relevant models are proposed as solutions to improving quality healthcare in Kenya through the RCC. For example, authors reviewed physician recruitment strategies, insurance plans and community engagement. The paper is informed by existing literature and reports as well as key informants.

This paper lacks primary data collection within Kenya and is limited to a brief scoping review of literature. The findings provide effective strategies for various business and franchising models in healthcare.

The assembling of relevant information specific to Kenya and potential business models provides effective means of improving health delivery through business and franchising, focusing on innovative approaches and models that have proven effective in other settings.

The purpose of this paper is to examine factors that may contribute to physicians’ dissatisfaction with their work environment, and subsequently, their likelihood to recommend a hospital to their peers.

A mixed method research design was used to identify, through qualitative interviews and focus groups, and measure, through quantitative surveys, physicians’ satisfaction with organizational communication, perceptions of empowerment and their likelihood to recommend a hospital to their peer physicians.

The results of the study indicate that physicians’ communication satisfaction and perceptions of empowerment contribute both directly and indirectly to their likelihood to recommend their organization to peers. The findings suggest that hospitals that facilitate positive workplace communications and provide work environments that allow professional discretion and autonomy are more likely to have satisfied physicians and positive word‐of‐mouth referrals.

Although multiple methods of data collection were used to triangulate the findings, there is the potential of common‐method variance and response bias from the use of single source questionnaire data. Ideally, future studies would use longitudinal data and a more comprehensive model of antecedents and consequences of physician satisfaction.

By understanding sources of physician dissatisfaction, hospitals can develop appropriate interventions to minimize the adverse effects of dissatisfaction on costs, quality of care, and physician turnover.

This study focuses on physicians’ satisfaction with their hospital work environment, an often overlooked area in studies of the health care industry that more commonly center on patient–physician satisfaction. The current study's results provide suggestions for better hospital management and further insight into the challenges of improving physician satisfaction in the health care industry.

Access to a continuum of care from a family physician is an essential component of health and wellbeing. Refugees have particular barriers to accessing medical care. The MUN MED Gateway Project is a medical student initiative in partnership with a refugee settlement agency that provides access to and continuity of health care for new refugees, while offering medical students exposure to cross-cultural health care. This paper aims to report on the first six years of the project.

Here the paper reports on: client patient uptake and demographics, health concerns identified through the project, and physician uptake and rates of patient-physician matches.

Results demonstrate that the project integrates refugees into the health care system and facilitates access to medical care. Moreover, it provides learning opportunities for students to practice cross-cultural health care, with high engagement of medical students and high satisfaction by family physicians involved.

Research has shown that student run medical clinics may provide less than optimum care to marginalized patients. Transient staff, lack of continuity of care, and limited budgets are some challenges. The MUN MED Gateway Project is markedly different. It connects patients with the mainstream medical system. In a context of family physician shortage, this student-run clinic project provides access to medical care for newly arrived refugees in a way that is effective, efficient, and sustainable.

Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of leadership roles for family physicians are absent from previous pandemic plans. This study aims to describe the leadership roles and functions family physicians played during the COVID-19 pandemic in Canada and identify supports and barriers to formalizing these roles in future pandemic plans.

This study conducted semi-structured qualitative interviews with family physicians across four regions in Canada as part of a multiple case study. During the interviews, participants were asked about their roles during each pandemic stage and the facilitators and barriers they experienced. Interviews were transcribed and a thematic analysis approach was used to identify recurring themes.

Sixty-eight family physicians completed interviews. Three key functions of family physician leadership during the pandemic were identified: conveying knowledge, developing and adapting protocols for primary care practices and advocacy. Each function involved curating and synthesizing information, tailoring communications based on individual needs and building upon established relationships.

Findings demonstrate the need for future pandemic plans to incorporate formal family physician leadership appointments, as well as supports such as training, communication aides and compensation to allow family physicians to enact these key roles.

The COVID-19 pandemic presents a unique opportunity to examine the leadership roles of family physicians, which have been largely overlooked in past pandemic plans. This study’s findings highlight the importance of these roles toward delivering an effective and coordinated pandemic response with uninterrupted and safe access to primary care.

If the use of information technology (IT) supporting clinical trial projects offers opportunities to optimize the underlying information management process, the intricacy of the identification and evaluation of relevant IT options is generally seen as a complex task in healthcare. Hence, the purpose of this paper is to examine the problem of ex ante information system evaluation, and assess the impact of IT on the information management process underlying clinical trials.

Combining Unified Modeling Language (UML) and system dynamics modeling, a simulation model for evaluating IT was developed. This modeling effort relies on a case study conducted in a clinical research organization, which, at that time, faced an IT investment dilemma.

Some illustrative results of sensitivity analyzes conducted on error rates in clinical data transmission are presented. These simulation results allow for quantifying the impact of different IT options on human resources' efforts, time delays and costs of clinical trials projects. Notably, the results show that although the technology has no real influence on the duration of a clinical trial project, it impacts the number of projects that can be carried out simultaneously.

The research provides insights into the development of an innovative approach appropriate to the evaluation of IT supporting clinical trials, through the use of a mixed‐method based on qualitative and quantitative modeling. The results illustrate two critical issues addressed in the IS literature: the necessity to extend IT evaluation beyond the quantitative‐qualitative dichotomy; and the role of evaluation in organizational learning, and in learning about business dimensions.

Like other European countries, Germany is facing regional physician shortages, which have several consequences on patient care. This study analyzes how hospitals perceive physician shortages and which strategies they adopt to address them. As a theoretical framework, the resource dependency theory is chosen.

The authors conducted 20 semi-structured expert interviews with human resource officers, human resource directors, and executive directors from hospitals in the northwest of Germany. Hospitals of different ownership types, of varying sizes and from rural and urban locations were included in the sample. The interviews were analyzed by using qualitative content analysis.

The interviewees reported that human resource departments in hospitals expand their recruiting activities and no longer rely on one single recruiting instrument. In addition, they try to adapt their retaining measures to physicians' needs and offer a broad range of employment benefits (e.g. childcare) to increase attractiveness. The study also reveals that interviewees from small and rural hospitals report more difficulties with attracting new staff and therefore focus on recruiting physicians from abroad.

Since the staffing situation in German hospitals will not change in the short term, the study provides suggestions for hospital managers and health policy decision-makers in dealing with physician shortages.

This study uses the resource dependency theory to explain hospitals' strategies for dealing with healthcare staff shortages for the first time.

Hospital information systems have evolved from data processing systems for patient billing and payroll to decision‐support systems which support decision making at the middle and upper management levels. With the advancements in the areas of database management, expert systems and networks, important hospital functions such as physician recruitment and referral which historically were performed using traditional procedures, are now performed using these computer‐based technologies. Develops a generalizable framework for information systems for physician recruitment and referral using technologies of database management, expert systems and networks. This GIS‐PRR system may be used by hospitals and other health‐care providers to improve the efficiency and effectiveness of the physician recruitment/ referral process.