Lindsay Sally
Institute for Social, Cultural & Policy Research, University of Salford, United Kingdom.
J Rural Health. 2007 Winter;23(1):72-6. doi: 10.1111/j.1748-0361.2006.00070.x.
Mid-level providers comprise an increasing proportion of the health care workforce and play a key role in providing health services in rural and underserved areas. Although women comprise the majority of mid-level providers, they are less likely to work in a rural area than men. Maldistribution of health providers between urban and rural practices is an important issue influencing health care.
To gain further insight into this issue, this study examined how mid-level practice location varied by gender.
Semistructured interviews were conducted with a purposive sample of 55 nurse practitioners, physician assistants, and nurse anesthetists in New York State and Pennsylvania.
Results suggest that family and community ties played a key role in influencing practice location. Men were particularly drawn to the broad scope of practice and autonomous nature of rural practice. Women in rural areas enjoyed the more personable environment and greater respect from colleagues and patients. Both male and female rural providers preferred their location because there were fewer turf issues, while some women were concerned about being professionally isolated. Meanwhile, both men and women enjoyed the fast pace, specialization, and greater opportunities urban areas had to offer.
Recruitment efforts should focus on candidates from rural areas and not underestimate the impact of family in decisions about work location.
中级医疗服务提供者在医疗保健劳动力中所占比例日益增加，在农村和医疗服务不足地区提供医疗服务方面发挥着关键作用。尽管女性占中级医疗服务提供者的大多数，但与男性相比，她们在农村地区工作的可能性较小。医疗服务提供者在城乡医疗机构之间分布不均是影响医疗保健的一个重要问题。
为了进一步深入了解这个问题，本研究调查了中级医疗服务提供者的执业地点如何因性别而异。
对纽约州和宾夕法尼亚州的55名执业护士、医师助理和麻醉护士进行了有目的抽样的半结构化访谈。
结果表明，家庭和社区关系在影响执业地点方面起着关键作用。男性尤其被农村执业的广泛业务范围和自主性所吸引。农村地区的女性喜欢更有人情味的环境，以及同事和患者给予的更多尊重。农村地区的男性和女性医疗服务提供者都更喜欢他们的工作地点，因为地盘问题较少，而一些女性则担心职业上的孤立。与此同时，男性和女性都喜欢城市地区提供的快节奏、专业化和更多机会。
招聘工作应侧重于来自农村地区的候选人，并且不要低估家庭在工作地点决策中的影响。
