Hostetter C L, Felsen J D
Public Health Rep. 1975 Jul-Aug;90(4):319-24.
Attracting physicians to serve in isolated areas, often with marginal facilities, support staff, and remuneration, has long been a problem of the Indian Health Service (IHS). Until recently the physician draft was instrumental in motivating physicians to accept such assignments. Realizing that this "negative incentive" would no longer operate when the draft ended as of July 1, 1973, in the fall of 1972 the IHS staff launched some major "positive" efforts to recruit physicians. The mass media and other communication techniques were used to try to sell U.S. physicians and medical students on what the Service could offer them in terms of adventure, challenge, personal fulfillment, idealism, and the opportunity to be part of a progressive, comprehensive health system. Such efforts assisted in recruiting 69 physicians to begin service in July 1973. These 69 were in addition to approximately 100 who had already been recruited from among persons who had expressed interest in joining the Indian Health Service or who had applied to it before inception of this major recruitment effort. As of July 1, 1973, however, the Service was still approximately 30 physicians short of filling 200 vacancies. In June and July of 1973, an evaluation was done to determine what had motivated the 169 physicians to join the Indian Health Service. They were asked an open ended question: What prompted you to seek employment with the Indian Health Service? Whether physicians listed personal, subjective motivators or recruitment techniques was of as much interest as the specific answers they gave. More than 75 percent (100 of 129) mentioned recruitment techniques, such as magazine advertisements, rather than personal motivating factors, such as challenge. Personal contact with a present or former IHS physician seemed to be especially influential in attracting physicians. The present state of the recruitment art does not provide the means to adequately identify, qualify, quantify, and rank the multiple motivators that prompt physicians to join a program such as that of the Indian Health Service; nor does it allow for meaningful, predetermined identification of a limited pool of physicians who would have a high probability of joining such a program. At present, the best recruitment strategy appears to be to saturate the entire physician "marketplace" stressing with a variety of techniques the positive aspects of IHS employment. Physicians then select themselves for such employment by exhibiting a more than casual interest in the Indian Health Service.
长期以来，吸引医生到偏远地区服务一直是印第安卫生服务局（IHS）面临的问题，这些地区往往设施简陋、辅助人员不足且薪酬不高。直到最近，医生征召制度在激励医生接受此类任务方面发挥了作用。1972年秋，IHS工作人员意识到随着1973年7月1日征兵制结束，这种“负面激励”将不再起作用，于是展开了一些重大的“积极”招募医生的努力。他们利用大众媒体和其他传播手段，试图向美国医生和医学生宣传该服务机构能为他们提供的冒险、挑战、个人成就感、理想主义，以及成为一个进步、全面的卫生系统一部分的机会。这些努力帮助招募了69名医生于1973年7月开始服务。这69名医生是在大约100名已经从表示有兴趣加入印第安卫生服务局或在这次大规模招募行动开始之前就已申请的人员中额外招募的。然而，截至1973年7月1日，该服务机构仍短缺约30名医生来填补200个空缺职位。1973年6月和7月进行了一项评估，以确定是什么促使这169名医生加入印第安卫生服务局。他们被问到一个开放式问题：是什么促使你寻求在印第安卫生服务局工作？医生们列出的是个人主观动机还是招募技巧，与他们给出的具体答案同样令人感兴趣。超过75%（129人中的100人）提到了招募技巧，如杂志广告，而不是个人激励因素，如挑战。与现任或前任IHS医生的个人接触在吸引医生方面似乎特别有影响力。目前的招募手段无法充分识别、评估、量化促使医生加入印第安卫生服务局这样的项目的多种动机，也无法有意义地预先确定一小群很有可能加入该项目的医生。目前，最佳的招募策略似乎是用各种技巧向整个医生“市场”大力宣传IHS工作的积极方面。然后，医生们通过对印第安卫生服务局表现出浓厚兴趣来选择这份工作。
