Following the call: How providers make sense of their decisions to work in faith-based and secular urban community health centers
The recruitment and retention of well-trained, motivated health care providers in underserved communities is a well described, longstanding, and refractory problem. In 1998, Singer and colleagues reported that the median tenure of primary care practitioners in federally funded community health centers (CHCs) is three years, regardless of National Health Service Corps obligations.1 Provider turnover exacts substantial tolls on the health care safety net. Patient care suffers from loss of continuity and trust,1,6 and it has been estimated that CHCs lose $150,000 to $300,000 in revenue and recruitment costs every time a provider position turns over.6 In response, some have argued that improving provider retention is essential to the stability and long-term missions of CHCs.1,7 Toward that end, researchers and policymakers have sought to understand the motivations for work among the underserved and to adjust the characteristics of these work settings in order to lessen the per sis tent ly high attrition rate.