Rural Community Variation in Physician RecruitmentReadiness

The capacity at which a rural community can mobilize resources involved in recruiting physicians has positive implicationsfor community health. The purpose of this study was to assess whether rural communities varied in their physician recruitmentreadiness. Methods： The Critical Access Hospital Community Apgar Questionnaire （CAH CAQ） was the instrument used in this study.Seventy one （71） rural communities in five US states who participated in the Community Apgar Program were included in this researchIn each rural community, the administrator of the critical access hospital and the physician/clinician with recruiting responsibilitiesparticipated individually in a structured interview. A total of 71 administrators and 71 physician/clinicians participated in the study（total N = 142）. Cumulative Community Apgar scores were calculated for each rural community. Descriptive statistics were calculatedfor this measure including means, standard deviations and coefficient of variations. No statistical differences were discerned acrossstate mean cumulative Community Apgar scores. Cumulative Community Apgar scores demonstrated variability within states and inthe aggregate across states. The five rural states included in this study showed similar distributions/patterns of cumulative CommunityApgar scores within their respective states. These distributions/patterns demonstrated variability in the cumulative Community Apgarscores in every state. Likewise, the aggregate distribution of cumulative Community Apgar scores demonstrated variability across thefive states. These rural communities vary in their physician recruitment readiness as measured by the CAH CAQ. As such,improvement efforts need to be customized for the specifics of the individual community. One size does not fit all.

Negotiating a new chair package:context and considerations

Negotiating a resource package as a potential new department chair is common practice in academic medicine.The foundations for this negotiation include the historical presence of the department in relation to the broader institution,projections for future growth,accounting for mission/vision,resource needs(space,personnel,finances,etc),faculty and staff development,and external partnerships within and outside the institution.Despite similarities in this process across departments,many nuances influence the development of a specific new chair package,such as,department size;desires,perspectives and talents of the incoming chair,the department faculty,the medical school and dean;prevailing agendas and mission imperatives;and the overall priorities of the institution.With strategy and forethought,a new chair package can promote a successful chair tenure and departmental growth.Assembled through the Association of Departments of Family Medicine with input from several dozen department chairs and senior leaders,this is intended to serve as a practical guide to new chair packages for chair candidates.