Primary care integration in rural areas: A community-focused approach.

Current and developing models of integrated behavioral health service delivery have proven successful for the general population; however, these approaches may not sufficiently address the unique needs of individuals living in rural and remote areas. For all communities to benefit from the opportunities that the current trend toward integration has provided, it is imperative that cultural and contextual factors be considered determining features in care delivery. Rural integrated primary care practice requires specific training, expertise, and adjustments to service delivery and intervention to best meet the needs of rural and underserved communities. In this commentary, the authors present trends in integrated behavioral health service delivery in rural integrated primary care settings. Flexible and creative strategies are proposed to promote increased access to integrated behavioral health services, while simultaneously addressing patient care needs that arise as a result of the barriers to treatment that are prevalent in rural communities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Physician wellness in rural America: a review.

OBJECTIVE: The primary purpose of this article is to review the unique wellness factors that affect physicians practicing in rural communities. Research has indicated that rural communities often struggle to attract and retain primary care physicians and numerous wellness factors impact these attraction/ retention rates. METHOD: Articles selected for inclusion in this review were determined based upon their relevance to rural physicians, overall wellness factors of physicians, and recruitment and retention of physicians in rural communities. Articles were included from peer-reviewed journals focusing upon both medical and psychological perspectives of rural physician wellness factors. RESULTS: Results indicated that rural physicians often have fewer resources, an increased workload, and longer hours when compared to their urban counterparts. These factors contribute to lower job satisfaction, poor retention rates, and decreased physician wellness. Research also demonstrates that physicians who are unwell are more likely to experience substance abuse, depression, relationship difficulties, and general psychological distress. These issues are particularly prominent in rural practice settings and may have significant impact upon rural patients. CONCLUSION: To date, there are few assessment measures available to assess physician wellness and no evidence-based treatments to address wellness deficits in rural physicians' medical or psychological health. Such resources would have the potential to benefit individual rural physicians and the quality of healthcare they deliver to rural communities. Future research should focus upon the assessment and promotion of rural physician well being, which may improve recruitment and retention of quality physicians to provide optimal care in rural communities.