Factors affecting the work of physicians in rural areas of Turkey.

INTRODUCTION An unbalanced geographical distribution of physicians leads to important differences in healthcare outcomes and difficulties in accessing healthcare services in rural areas. As in many other countries in the world, the geographical distribution of physicians in Turkey is unbalanced. Although there has been an increase in the number of physicians in the rural areas of Turkey since the introduction of the Health Transformation Program in 2003, health statistics indicate that significant differences still exist between regions in terms of the population-to-physician ratio. The aim of this study was to determine the factors that affect physicians' decisions about working in rural areas in Turkey. METHODS Overall, 1340 physicians working in urban areas constituted the sample group of this study. A survey method was used to collect the data. The questionnaire, which was used as a data collection tool, included nine questions to gather the opinions of physicians regarding working in rural areas. Variables such as occupational group and financial incentives affecting the physicians' willingness to work in rural areas were analyzed with descriptive statistics, and the answers given according to these variables were compared via t-test and one-way analysis of variance. RESULTS Of the sample, 59.9% of the participant physicians were men, and 36.9% were specialists. Opinions of the physicians about working in the rural areas differed significantly by occupational group, marital status and income. Medical residents and general practitioners were more willing to work in rural areas than other profession groups. In addition, single physicians were more open to working in rural areas than were married physicians. An increase in physicians' income reduced their willingness to work in rural areas. The developmental level of the region where they worked was found to be a very important variable affecting their preferences. Participants working in developed regions are reluctant to work in the rural areas. CONCLUSIONS Specific occupational groups, young and single physicians, and physicians working in underdeveloped regions were found to be the groups that can more easily be motivated to work in rural areas. To encourage physicians to work in rural areas, monetary and non-monetary incentives should be considered.