In their study of the effect of rural background and clinical rural rotations on subsequent practice location, Mark Easterbrook and colleagues failed to address a factor that is intuitively important in determining whether physicians choose to practise in a rural area: influence of the physician's spouse. [1] Practice location has been shown to be determined in part by the spouse's preferences. [2–5] A 1985 study showed that, in addition to physician background (including the size of the community where the physician grew up and the size of the physician's high school graduating class), the background of the physician's spouse was a significant factor affecting recruitment and retention of physicians in rural practice. [2] Rural communities appear to appeal to spouses who are from rural communities themselves and who find job opportunities in the area. [2, 5]
I am a rural physician, and my wife is from a rural area. We have been very happy living in small communities in Canada. Future studies should take spousal factors into account to determine what rural communities can do to become more attractive to prospective physicians and their spouses.
Adam Poradzisz, MD
Edmonton, Alta.