Journal Articles

Listed by publication date. You can also view these publications alphabetically.




  • Do Residencies that Aim to Produce Rural Family Physicians Offer Relevant Training?
    WWAMI Rural Health Research Center
    Date: 09/2016
    Examines the rural-centric family medicine residencies, their training locations, and rurally relevant skills training provided. Rural training can promote rural practice, but the number of family medicine residencies with a rural focus, geographic distribution of training, and training content are poorly understood.
  • Nurse Practitioner Autonomy and Satisfaction in Rural Settings
    WWAMI Rural Health Research Center
    Date: 01/2016
    Compares urban and rural primary care nurse practitioners (NPs) by practice location in urban, large rural, small rural, or isolated small rural areas by using analysis of the 2012 National Sample Survey of NPs.


  • The Rural Obstetric Workforce in US Hospitals: Challenges and Opportunities
    University of Minnesota Rural Health Research Center
    Date: 03/2015
    Describes the healthcare and clinician types who are delivering babies in rural hospitals, such as family physicians, general surgeons, obstetricians, and midwives. Discusses the relationship between hospital birth volume and staffing models.




  • The Washington State Nurse Anesthetist Workforce: A Case Study
    WWAMI Rural Health Research Center
    Date: 02/2007
    The purpose of this study was to describe the Washington State Certified Registered Nurse Anesthetist (CRNA) workforce and analyze selected dimensions of their clinical practice.
  • Urban-Rural Flows of Physicians
    North Carolina Rural Health Research and Policy Analysis Center
    Date: 2007
    Reports findings from a study to determine whether there was a significant flow of physicians from urban to rural areas in recent years when the overall supply of physicians has been considered in balance with needs.





  • Accounting for Graduate Medical Education Funding in Family Practice Training
    WWAMI Rural Health Research Center
    Date: 10/2002
    Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding.
  • Family Medicine Training in Rural Areas
    WWAMI Rural Health Research Center
    Date: 09/2002

    Letter to the Editor: The discipline of family medicine was created in the 1970s, in part, as a way to address the chronic shortage of US rural physicians. It was predicted that the new discipline would augment the supply of rural clinicians because family physicians are much more likely than other physicians to settle in rural areas.

    There is also empirical evidence that training family physicians in rural areas increases the likelihood that residency graduates will choose to settle in rural places. However, the exact proportion of family medicine residency programs located in truly rural parts of the United States remains unknown, as does the extent to which training rural physicians is a priority of existing family medicine residency programs.

  • Rural-Urban Differences in the Public Health Workforce: Findings From Local Health Departments in three Rural Western States
    WWAMI Rural Health Research Center
    Date: 07/2002

    Most local health departments or districts are small and rural; two thirds of the nation's 2832 local health departments serve populations smaller than 50,000 people. Rural local health departments have small staffs and slender budgets, yet they are expected to provide a wide array of services during a period when the healthcare system of which they are a part is undergoing change.

    This study provided quantitative, population-based data on the supply and composition of the rural public health workforce in 3 extremely rural states: Alaska, Montana, and Wyoming. The study focused on the relative supply of personnel in the principal public health occupational categories, differences across states in staffing levels, and difficulties experienced in recruiting and retaining personnel.


  • Local Health Districts and the Public Health Workforce: A Case Study of Wyoming and Idaho
    WWAMI Rural Health Research Center
    Date: 2001
    Studies personnel in local health departments (LHDs) focused on two predominantly rural states: Idaho and Wyoming. Although in the same region of the country, the structure of local public health is different in each state.
  • National Estimates of Physician Assistant Productivity
    WWAMI Rural Health Research Center
    Date: 2001
    Analysis of productivity data from a nationally representative sample of physician assistants (PAs) showed that PAs performed 61.4 outpatient visits per week compared with 74.2 visits performed by physicians. However, productivity of PAs varies strongly across practice specialty and location.


  • U.S. Medical Schools and the Rural Family Physician Gender Gap
    WWAMI Rural Health Research Center
    Date: 05/2000
    Women comprise increasing proportions of med school graduates. They tend to choose primary care but are less likely than men to choose rural practice. This study identified the U.S. medical schools most successful at producing rural family physicians and general practitioners of both genders.
  • The Distribution of Rural Female Generalist Physicians in the United States
    WWAMI Rural Health Research Center
    Date: 2000
    Female physicians are underrepresented in rural areas. What impact might the increasing proportion of women in medicine have on the rural physician shortage? To begin addressing this question, we present data describing the geographic distribution of female physicians in the United States.
  • Educating Generalist Physicians for Rural Practice: How Are We Doing?
    WWAMI Rural Health Research Center
    Date: 2000
    About 20 percent of Americans live in rural areas, 9 percent of physicians practice there. Physicians consistently settle in metropolitan, suburban, and other nonrural areas. This report summarizes the successes/failures of medical education and government initiatives intended to prepare and place more generalist physicians in rural practice.



  • Availability of Anesthesia Personnel in Rural Washington and Montana
    WWAMI Rural Health Research Center
    Date: 03/1998
    Anesthesia has historically been an undersupplied specialty. Health personnel issues used to be dominated by the findings of the 1980 Graduate Medical Education National Advisory Committee study, which suggested that anesthesia would be a balanced specialty for the rest of the century. Recent studies, however, have demonstrated that there is an oversupply of all specialists, including anesthesiology. These studies take a "top down" view of health personnel through analysis of national statistics and exploration of subsets of the data by hospital size and rurality. This approach assumes that the databases of the American Hospital Association and the American Medical Association are accurate and do not take into account the presence of certified registered nurse anesthetists (CRNAs), who are the predominant providers of anesthesia care in the smallest and most remote hospitals in the United States. We compared the 1994 master file of the American Medical Association with our local knowledge of the practitioners in the rural areas of Washington state and found numerous small errors. These errors of one or two practitioners made no difference to the analysis of practitioner groups with more than approximately five people, but in the most rural communities the erroneous presence or absence of a single practitioner made a significant difference.


  • The National Health Service Corps: Rural Physician Service and Retention
    WWAMI Rural Health Research Center
    Date: 07/1997
    The National Health Service Corps (NHSC) scholarship program is the most ambitious program in the US designed to supply physicians to underserved areas, in addition the NHSC promotes long-term retention of physicians in the areas to which they were initially assigned. This study explores some of the issues involved in retention in rural areas.