Physician Scope of Practice

Impact of Rural Exposure on Desired Scope of Practice

Preliminary data from a comparative study of MAHEC family medicine residency programs in Asheville and Hendersonville, NC indicate that residents in both programs desire a broader scope of practice than is currently provided by their rural preceptors. The largest gaps in desired versus actual practice were in inpatient and outpatient obstetrics and inpatient pediatrics and inpatient adult medicine.

Other findings support previous research that suggests rural exposure during medical school and residency increases the likelihood of choosing a rural practice in the future, particularly when combined with a rural background.

Principal investigators: Bryan Hodge, DO, MAHEC Hendersonville Family Medicine Residency; Jill Fromewick, ScD, and Lauren Payne, Department of Research, UNC Health Sciences at MAHEC.

Factors Influencing Scope of Practice

Qualitative research is being conducted with MAHEC residency program graduates to understand residents’ expectations, employer needs, and physician scope of practice in Western North Carolina. Based on analysis of the qualitative data, the collaborative research team is developing a conceptual framework to explain how personal, environmental, workplace, and population factors influence desired and actual scope of practice. Research findings will inform future recruitment, workplace optimization and workforce training needs.

Principal investigators: Amy Russell, MD, vice president and chief of Community Medicine at Mission Health, MAHEC family medicine faculty; Jill Fromewick, ScD, and Kara Franke, MPH, Department of Research, UNC Health Sciences at MAHEC.