Sinclair-Lian Nityamo, Rhyne Robert L, Alexander Shirley H, Williams Robert L
Department of Family and Community Medicine, University of New Mexico School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
J Am Board Fam Med. 2008 Jul-Aug;21(4):353-5. doi: 10.3122/jabfm.2008.04.080022.
Professional isolation is a barrier to practicing in rural and underserved communities. The purpose of this study was to investigate the association between membership in a practice-based research network and the length of employment in members' and nonmembers' current clinic sites.
This was a cross sectional study of 7 group practices (2 urban and 5 rural groups comprising 22 clinic sites) throughout New Mexico that had RIOS Net member and nonmember practicing clinicians.
The 22 clinics employed 95 clinicians, of which 43% were RIOS Net members (21 of 59 MDs, 8 of 18 Nurse Practitioners, 9 of 15 Physician Assistants and 3 of 3 others). RIOS Net members had a significantly longer mean employment time (7.0 years; SD, 6.8 years; median, 5.0 years), compared with non-RIOS Net members (4.0 years; SD, 5.0 years; median, 2.3 years; P = .003). Similar results were found when analyzed by length of time in practice with cutoffs of 2 and 5 years.
Being a member of a practice-based research network may be a determinate of staying in rural practice longer. This is a hypothesis-generating study and needs confirmation from larger studies whose analysis stratifies clinician demographics and practice type.
职业孤立是在农村和医疗服务不足社区执业的一个障碍。本研究的目的是调查参与基于实践的研究网络与成员和非成员在当前诊所工作时长之间的关联。
这是一项对新墨西哥州7个团体诊所（2个城市诊所和5个农村诊所，共22个临床地点）进行的横断面研究，这些诊所中有RIOS Net成员和非成员执业临床医生。
这22家诊所雇佣了95名临床医生，其中43%是RIOS Net成员（59名医生中的21名，18名执业护士中的8名，15名医师助理中的9名以及其他3人中的3名）。与非RIOS Net成员（4.0年；标准差5.0年；中位数2.3年）相比，RIOS Net成员的平均工作时间显著更长（7.0年；标准差6.8年；中位数5.0年；P = 0.003）。在按执业时长（以2年和5年为界限）进行分析时也发现了类似结果。
成为基于实践的研究网络的成员可能是在农村长期执业的一个决定因素。这是一项产生假设的研究，需要来自更大规模研究的证实，这些研究的分析要对临床医生的人口统计学特征和执业类型进行分层。
