[One of the authors responds:]
I thank Dr. Poradzisz for his comments on our article. [1] We looked at the relative effects of a physician's exposure to rural communities, comparing the effect of having grown up in a rural community with the effect of exposure to rural communities during training. We found that prior residence in a rural community was a stronger predictor of practice location. As Dr. Poradzisz points out, the origins of the spouse have also been shown to be an important factor. Since we also had these data we looked at the effect of having a spouse from a rural community (10 000 or fewer people) and found that it was an independent predictor of a physician deciding to practise in a rural community (crude odds ratio 31, 95% confidence interval 1.5-6.4, p = 0.003). This does not change our results, but rather it strengthens the finding that rural background influences rural practice decisions.
Marshall Godwin, MSc, MD
Department of Family Medicine; Queen's University; Kingston, Ont.
References
- 1.↵