Despite lingering perceptions that healthcare in rural areas is inferior to that offered in big cities, physicians who work in both environments share largely similar professional beliefs and behavior, according to a new study published in the Journal of Rural Health.
One area in which rural physicians are more engaged, however, is quality improvement, including activities such as peer review and recertification. The study found:
- More than half (52 percent) of rural primary care physicians (PCPs) were significantly more likely than their urban counterparts (36 percent) to feel prepared to participate in quality improvement activities in their practices and hospitals.
- Sixty-one percent of rural PCPs reported engaging in formal medical-error-reduction initiatives compared to 51 percent of urban physicians.
- Most (66 percent) rural physicians said that they reviewed another physician's records for quality improvement, compared to 48 percent of urban physicians.
On the flipside, PCPs in rural areas reported feeling less prepared than urban doctors to critically evaluate new clinical knowledge, according to the study, which included 1,891 physicians in family medicine, internal medicine and pediatrics.
And although city and country doctors agreed on the need to report impaired colleagues and disclose medical errors, rural physicians were significantly more likely to recognize an impaired or incompetent colleague. The research did not determine whether this difference was because there were more compromised physicians in rural areas, or small communities simply made it more difficult to keep problems secret. Physicians in all regions reported similar challenges in actually reporting troubled colleagues, however.
"Our findings suggest a deep and broad agreement among primary care physicians on the key tenets of medical professionalism, regardless of the location of their practices," study leader Eric G. Campbell, Ph.D., director of research at the Mongan Institute for Health Policy at Massachusetts General Hospital and professor of medicine at Harvard Medical School, said in a statement.
Rural doctors, though more likely to talk to their patients about cost of care, may not be as drug conscious as they could be, Campbell added, something researchers want to explore further, since a significant number of patients enrolling in Affordable Care Act-sponsored health plans are from rural areas.