The evaluation of doctors' motivation to work at hospitals in the rural areas

Aim of the study. To identify and analyze the doctors’ motivation aspects to work at hospitals in the rural areas. Objectives. 1. To identify the main factors that influence the doctors’ decision to work at hospitals in the rural areas. 2. To determine the problems that doctors are facing in their beginning at work in the rural areas. 3. To investigate the doctors’ opinion about the instruments that were used or could be adopted in practice to attract and retain doctors in rural hospitals. Methods. Qualitative study was used to get the information which contains motivating factors for doctors to work at the rural hospitals. Using in-deph semistructured questionnaires were asked 8 residency students and 3 doctors at rural hospitals. Respondents were selected using short (less than 3 years) working period in rural hospital criteria. Results. Lower competition in labor market and higher salaries are the push factors for doctors to choose the rural workplace. Most of the doctors request the hospitals directly for the vacant positions or get the information about available positions from people they know. Rural hospitals attract doctors with higher wages, refund the payment of residency studies and adjust a better working schedule. The incentives of universities should be better developed because there is lack of rural practice possibilities for the students. There is indeed strong influence made by lecturers who spread negative and inadequate approach about rural hospitals. Doctors gain various skills in rural hospitals, which sometimes are over the boundaries of their specialty. Despite the equipment shortage, poor professional support from colleagues, doctors are satisfied with relations with patients, who trust and respect doctors more than in the cities. Conclusions. 1. The decision to work at rural hospitals is influenced by salary, location of parents and distance from big cities factors. Undeveloped infrastructure for children education, difficult situation to find job for spouse, lack of activities in rural areas are considered as the motivating factors not to choose the rural workplace. 2. Shortage of medical equipment, lack of competence for medical personnel and the old-time working instructions causes the professional development issues. 3. The most used rural hospitals’ incentives to attract doctors are salaries, bonding schemes, more flexible working schedule, meanwhile implements of universities could be more improved solving uneven distribution of doctors in the country