Factors that contribute to rural provider retention, service utilization, and engagement in mentorship by cultural experts

Abstract

A substantial amount of time, money, and other resources are expended on recruiting behavioral health providers to fill vacant positions in rural Alaska. This exhaustive drain on resources is perpetual due to the high turnover rates of providers. This exploratory qualitative study utilized grounded theory methodology to investigate personal qualities of providers and other factors contributing to long-term retention of providers relocating to Alaska's Bering Strait Region from elsewhere, community members utilizing the provider's services, and the provider's engagement in cultural mentorship to facilitate the integration of culture into their practice. Furthermore, factors contributing to local provider retention were examined. Key informant interviews were conducted with 21 healthcare providers living and working in the region long-term. A theory emerged that connected provider retention to community member service utilization and cultural mentorship. Results indicated that providers who are open, willing to learn, good listeners, calm, friendly, respectful, flexible, compassionate, genuine and possess a sense of humor, humility, and ability to refrain from imposing personal values, beliefs and worldviews upon others are a good fit for living and work in rural Alaska. Such qualities facilitate a provider achieving professional and personal satisfaction through building relationships and creating opportunities for cultural mentorship, professional support, and social support. These opportunities enhance the delivery of quality services that are culturally appropriate and well-utilized by community members, which, in turn, increase provider satisfaction and retention. Recommendations are made to healthcare organizations regarding recruitment and retention strategies. Recruitment strategies include careful screening of potential applications for specific qualities and enlisting local community members and students into the healthcare field. Retention strategies include professional support by way of a comprehensive orientation program, clinical supervision, cultural mentorship, and continuing education training opportunities that focus on cultural competency. Recommendations for retention of local providers include professional development incentives and opportunities that qualify local providers for positions typically held by outside providers.