Why Incentives to Attract Doctors to Rural Areas Haven’t Worked

Arjun Sharma in Undark: IN THE 1960s and 1970s, researchers offered financial incentives to patients to get them to lose weight, quit smoking, and abstain from alcohol. To some degree, it worked. But when (U.S.) governmental bodies proffered a pecuniary boon to physicians to move their practice to rural areas, the outcomes were less clear-cut. In fact, new evidence suggests that such monetary incentives barely move the needle.

In 1965, as Medicare was being launched (in the U.S.), state lawmakers were in the process of identifying regional gaps in the American health care landscape. These places, which were designated under the nationally established Health Professional Shortage Area program, or HPSA, disproportionately lacked medical practitioners and are now areas where a single physician could be tasked to juggle the health of thousands of people. Such medical deserts include more than 5,300 rural areas, in which almost 33 million people face a dearth of primary care services. More here.

In Pakistan it’s mainly about ‘Basic Facilities’: RELUCTANCE TO SERVE IN RURAL AREAS: DOCTORS’ PERSPECTIVE (Sep 2017)
200 doctors comprising of 113 males and 87 females were recruited for the study. The mean age was 30 years (0.65 SD). Majority (86.5 %) of the doctors were of the view; that indeed it was the non-availability of doctors at rural health care centres for poor health services in such areas. 83.9 % agreed that basic facilities were lacking in rural areas. Regarding transportation, 74.5 % had the opinion that these facilities were inadequate in rural areas. Nevertheless, 84.5 % agreed that by improving the basic facilities of life, working conditions could be improved. However, 72.5 % supported the idea of extra hard area grant to improve doctors’ motivation towards serving rural areas.
Conclusion: Doctors were reluctant to serve in rural areas because of the difficulties affecting their social, professional and family life. By developing the infra-structure of health centres and by providing some special incentives to the serving doctors, this issue can be resolved to a considerable extent. More in Pakistan Journal of Public Health>

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