Volunteer physician faculty and the changing face of medicine

To determine the extent to which current changes in the American health care system might adversely effect the willingness of community physicians to volunteer to teach medical students.

Surveys in the form of 2 mailings were sent to 466 physicians in the Pacific Northwest who volunteer to teach first- and second-year medical students. The physicians were categorized into medical specialty or primary care, urban or rural location, and type of practice.

A total of 333 physicians completed the surveys on which responses were analyzed.

Respondents noted that clinical and nonclinical workloads had increased (n=211 [63%] and n=276 [83%], respectively) in the past 5 years. One hundred eighty-six respondents (56%) said that they had less time for teaching medical students. Forty-five physicians (14%) indicated that they had discontinued their volunteer teaching activities altogether. During the past 5 years, solo practitioners had the lowest dropout rate (7% [4/57]), and physicians at health maintenance organizations had the highest (23% [7/30]). Primary care physicians were more likely to indicate that they had decreased time for each patient encounter (P=0.006).

Increasing nonclinical workload demands and higher patient loads are a substantial threat to the recruitment and retention of volunteer faculty. In particular, the involvement of urban, HMO, and primary care physicians may decrease disproportionately in the future.