Poster Paper: Exploring Determinants for Recruitment and Retention of Family Doctors for Rural Practice in Vietnam: Lessons from a Discrete Choice Experiment

Saturday, November 5, 2016
Columbia Ballroom (Washington Hilton)

*Names in bold indicate Presenter

Anh Pham, University of Texas at Dallas

Critically, the chronic doctor shortage experienced by rural communities in Vietnam has brought a concern for the lack of continuity between level of care and lack of trust by patients in primary health care centers. Given its expertise in outpatient clinical care across the life span of patients, Family Medicine, which was built as first-degree specialty since 2001, becomes an ideal fit to partially relieve the doctor shortage in underserved areas and therefore improves primary health care in Vietnam. However, despite the gradually increased number of trainees enrolled in recent years, family medicine trainees who had rural working experiences is much less than those who did not. Furthermore, only a little portion of family doctors decided to return to community health centers after getting their degree.

A number of strategies were designed and implemented to attract and retain doctors in rural and remote areas. However, promulgated policies of developing human resources for rural health in Vietnam have been considered inefficient. Health policymakers often find it daunting to select the most appropriate intervention(s) among a “laundry list” identified by qualitative studies. Moreover, none of these studies focused on attracting and retaining family doctors. Therefore, I argue there is a need of a comprehensive and quantitative study to understand the determinants of recruiting and retaining family doctors for rural practice in Vietnam, which can serve a guide for more effective policy decision and implementation.

The field-based data collection is carried out in four universities in Vietnam, including Ho Chi Minh University of Medicine and Pharmacy, Hue University of Medicine and Pharmacy, Hanoi Medical University and Haiphong Medical University. They are located in the four large cities throughout the entire Vietnam, which helps this study to cover a variety of possible characteristics of family medicine students. I employ a discrete choice experiment (DCE) method, a quantitative technique for eliciting individual preferences by asking individuals to state their choices over the sets of hypothetical alternatives.

The project involves a range of activities including: (1) conducting a series of focus groups and in-depth interviews with health policymakers, health professionals, and family medicine students in Vietnam to explore key variables of interest, (2) conducting a pilot survey to evaluate a draft questionnaire before finalizing the attributes and their levels for the DCE, (3) recruiting and training interviewers, and (4) interviewing family medicine students in the four selected universities.

Research findings are expected to allow policymakers in Vietnam to answer the following research questions: (1) Are there any identifiable characteristics associated with future family doctors who would return to rural and remote areas after getting their degree? (2) What intervention or incentive could keep future family doctors who previously worked in rural and remote areas after getting their degree? (3) What interventions could influence future family doctors without rural experience to choose rural practices after getting their degree? (4) Are there any significant and meaningful difference between future family doctors who might serve in rural and remote areas and who insist on serving in urban areas?