Year of Publication



Martin School of Public Policy and Administration

Date Available


Executive Summary

There is a physician shortage in eastern Kentucky because older physicians are retiring, and younger physicians are choosing to practice in more urban, affluent areas. Eastern Kentucky is plagued with persistent poverty and lacks cultural amenities. These facts put together myths regarding rural practice create a shortage.

My research consisted of interviewing twenty physicians currently practicing at Highlands Regional Medical Center in Prestonsburg, Kentucky. I created a survey instrument that asked questions of physicians regarding demographics characteristics, medical school attended, and what motivated them to practice at Highlands. I chose Highlands because I was able to get interviews scheduled with their physicians; however, this made my results ungeneralizable to other physicians in the area. Ideally, I would have interviewed physicians from all areas in eastern Kentucky, but it was not feasible within the time and resource limitations of this project. Therefore, this project should be considered an exploratory foundation for subsequent attempts to understand what factors are associated with physicians’ decisions to locate in eastern Kentucky.

My findings were consistent. All twenty physicians answered that their main motivators for choosing to practice at Highlands were salary or the desire to return home and be close to family. I also reported what I called secondary motivators which were loan repayment assistance, desire to help an underserved population, assistance from Highlands in establishing their practice and the Highlands administration being easy to work with. Although physicians said these factors were important, they were not the main reason given for the decision practice at Highlands.

Based on my findings, I recommended that Highlands recruit physicians who have lived in eastern Kentucky because they understand the population they will be serving and are accustomed to the lack of amenities. I also recommend that Highlands continue to offer physicians competitive salaries. Foreign Medical Graduates appeared to assimilate to the area, so Highlands could also recruit more Foreign Medical Graduates.



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