Date of Conferral

8-20-2025

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Human Services

Advisor

Miriam Ross

Abstract

Physician shortages in rural areas represent a serious and escalating challenge in the United States, with approximately 20% of the population residing in these regions while only about 9% of physicians practice there. The purpose of this integrative review was to identify key underlying factors contributing to physician shortages in rural hospital health settings and identify potential strategies to recruit and retain physicians. The review question concerned strategies and practices administrators use to attract and retain physicians in underserved rural areas. Herzberg’s two-factor theory serves as the framework and offers a perspective on employee motivation and job satisfaction. A review of empirical and nonempirical literature published from 2019 to 2025 identified 125 articles. After exclusion criteria were applied, 25 articles were identified for in-depth analysis using the Johns Hopkins evidence-based practice model. The articles provided five main themes: improving physician education, strengthening physician autonomy, financial incentives, support for lifestyle/personal preferences, and enhancing understanding of government policies. Fourteen subthemes aligned with the main themes; the most significant were training and education opportunities, personal and professional development, positive work environment, a sense of belonging, and financial support programs. Recommendations included developing targeted recruitment strategies, offering rural-focused medical education, promoting professional collaboration, and encouraging community integration. Implementing these recommendations may enhance access to physicians in rural hospital health systems, thereby strengthening various social determinants of health and contributing to improved health outcomes for residents, ultimately fostering positive social change.

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