Biomedical subjects

M P Cutchin

Publications and source records attributed to M P Cutchin.

5 recordsLinked to original sources

PubMed2001

Deweyan integration: moving beyond place attachment in elderly migration theory.

The fact that aging-in-place and elderly migration are intricately linked has been overlooked by behavioral approaches to elderly migration. "Humanistic" inquiry has provided important insights into aging-in-place and elderly migration as well as the connection between the two. Humanistic approaches, however, do not encapsulate the full range of experience involved in elders' lives. To move beyond humanistic research and key concepts such as place attachment, the philosophy of John Dewey is introduced. Dewey's viewpoint is merged with the geographical concept of place into what is termed "place integration." This perspective is subsequently compared with humanistic perspectives on aging-in-place and elderly migration decision-making. Fundamental differences such as temporal orientation and substantive focus are illustrated and discussed. Conclusions address the utility of such a perspective.

Aged↗

PubMed1997

Community and self: concepts for rural physician integration and retention.

Low physician availability in rural areas of the United States is a long-standing issue. While most research has focused upon the locational decisions of physicians to understand the causes of the problem, a relatively new and neglected research focus is the retention of rural physicians. This paper takes the perspective that integration of physicians within rural communities is the basis for retention. It introduces concepts of self and community as a basis for understanding "domains" of rural physician integration. From data collected during in-depth qualitative research in rural Kentucky, a framework of integration domains is developed. The three domains of physician self, medical community, and community-at-large are elaborated with examples from the data. To further explain the relationships among the integration domains and their value, the findings are combined with three concepts from social theory. Social capital, core participation, and community reconstruction add dynamic and meaningful aspects to the context in which integration and retention occur, and they provide a conceptual basis to use when investigating or devising actions to facilitate integration.

Attitude to Health↗

PubMed1997

Physician retention in rural communities: the perspective of experiential place integration.

Rural communities across the United States continue to struggle in their attempts to recruit and retain physicians. In response to this ongoing problem, health services researchers have focused on the recruitment of physicians. More recently, however, researchers have recognized the importance of physician retention. Nonetheless, there is a scarcity of theories to explain the process of rural physician retention. This paper provides an overview of retention in health services research. It then proposes a theoretical perspective on retention called "experiential place integration." The paper subsequently presents an in-depth qualitative study of rural physician integration in Kentucky from which a practical framework of physician integration is constructed. The framework represents integration as an active developmental process based on the enhancement of security, freedom, identity and meaning in place.

Adult↗

PubMed1994

General practitioner distribution and population dynamics: Munich, 1950-1990.

The problem of variable geographic distribution of physicians appears to be universal and intransigent. There is growing evidence from several developed countries of primary physicians avoiding areas in large cities increasingly populated by poor and ethnic minorities. This paper extends the research to Germany. Here, the changing population structure of Munich from 1950 through 1990, characterized by a large influx of foreign guestworkers, is illustrated. Selected changes in the medical care system and the role of the general practitioner pertinent to the question of supply and distribution are also discussed. Within this context, the geographic distribution of general practitioners' offices is examined for possible response to the concentration of foreigners in Districts within the City. In the aggregate, the distribution of general practitioners follows the geographic trends of the general population during the study period. However, geographic distribution of general practitioners varies widely on a District by District assessment. Though the exception, in several Districts there are indications that general practitioners may be avoiding locating offices in areas characterized by high density of foreign populations. This paper also draws attention to the importance of investigative scale to conclusions relating general practitioner distribution to spatial-temporal population trends.

Avoidance Learning↗

PubMed1994

To stay or not to stay: issues in rural primary care physician retention in eastern Kentucky.

An important aspect of primary care physician availability is the retention of physicians once they have located. While retention has been under-researched compared to recruitment, it is especially important in rural areas where physician shortages already exist. This study reports the results of a retention survey completed by 132 primary care physicians in rural eastern Kentucky. The survey sets up an objective, hypothetical retention scenario and asks physicians to respond to structured questions and to an open-ended question about factors not appearing in the survey. In response to the structured portion of the survey, physicians indicate that relief coverage is the most important factor in rural physician retention. A content analysis of 75 open-ended responses reveals that besides the other factors in the survey, "sociocultural integration" is the pre-eminent retention issue for rural practitioners. This article concludes that the role of the local rural community may be more important in retention than in recruitment. Finally, it is suggested that additional in-depth qualitative research be conducted within the local contexts to enhance the understanding of rural physician retention processes.

Attitude of Health Personnel↗