docsonfarmsNo matter if a rural doctor is wearing boots, plaid or a cowboy hat, his or her professional attitudes and beliefs are similar to those found in big-city physicians with windows overlooking Times Square. At least that’s the conclusion gleaned from a survey published in the Journal of Rural Health.
What the Survey Did
The study looked at physicians across the nation to compare the attitudes and behaviors between rural and urban doctors. While personal attitudes and behaviors may have been a highly enticing area to research, especially for rural doctors who happened to live on goat farms, the study stuck to attitudes and behaviors at the professional level.
The study started with a hopeful 3,500 potential responses, yet quickly found 562 “were ineligible.” Reasons were having a specialty outside the scope of the study, being on leave, no longer actively practicing medicine or being dead. Researchers further eliminated an additional chunk of practitioners who were not primary care doctors, ending up with about 840 completed surveys they could use.
The survey touched on primary care physicians in three specialties. A total of 67.5 percent of the respondents were in family medicine, 60.8 percent were in general internal medicine and 72.7 percent were in pediatrics. The differentiation between urban and rural was based on the doctor’s zip code.
As population statistics would dictate, the survey ended up with a much greater number of responses from urban doctors, but that by no means meant that urban physicians necessarily outweighed their rural counterparts when it came to quality health care.
Where Urban and Rural Were the Same
Urban and rural doctors heartily agreed that it was vital to disclose medical errors and tattle on colleagues that were incompetent or impaired.
Where Urban Outweighed Rural
Although urban and rural docs were equally as willing to rat out an incompetent or impaired colleague, urban doctors were more likely to actually spot or recognize one. Urban doctors also won out for preparation, specifically in the area of being more prepared than rural docs to evaluate new clinical knowledge.
Where Rural Outweighed Urban
Quality improvement was huge with rural physicians, with rural primary care physicians “significantly more likely” than urban docs to partake in quality improvement activities in hospitals and their practices. While the survey did not note if that eagerness for improvement was linked to working in environments that could certainly use it, it did note that 52 percent of rural docs felt prepared to give it a go, compared to 36 percent of urban doctors.
Other notable areas where rural doctors outshone the urban included:

  • Formal medical-error-reduction practices: 61 percent of rural doctors said they felt prepared to engage in strategies to reduce errors, compared to 51 percent of their urban counterparts.
  • Peer reviews: 66 percent of rural physicians reported reviewing another doctor’s records to help improve quality, compared to only 48 percent of urban docs.

Rural docs were additionally:

  • More likely to talk to patients about the cost of care
  • More attentive to recertification
  • Not “as drug conscious as they could be”

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One More Area of Potential Agreement
Another area of agreement, or at least an area where most would hope all doctors agree, is in the area of medical billing best practices. Not only should best practices conform to guidelines dictated by those things called regulations, but they should also be accurate, honest, transparent and easy to administer.
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Last Updated on March 3, 2014