Date of Award

Fall 2015

Document Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Andy Coburn


primary care physician retention, primary care physican recruitment, rural residency programs, incentive programs, healthcare distribution, rural Maine, Muskie School of Public Service


Maine faces a challenge providing primary care services to over half of its residents, as they live in rural areas – even though Maine has enough primary care physicians practicing in the state to service the needs of the population. Maine has a primary care physician distribution problem. Androscoggin, Oxford, Sagadahoc, Somerset, Waldo, Washington, and York Counties, all fall well below the national average of primary care physicians per 100,000 residents. Maine has no true financial incentive program to help rural area’s recruit and retain primary care physicians, though Maine does have two programs that attempt to get primary care physicians to rural areas, The Maine Health Professions Loan Program, and the Doctor’s for Maine Future Scholarship.

Based on the analysis conducted in this paper, five recommendations/policy options were made, to increase the number of primary care physicians practicing in the states rural and underserved areas. Reverting the changes made to the Maine Health Professions Loan Program would provide Maine with financial incentive package (even though the changes may need to be adapted to compete with other states). Expanding the Opportunity Maine Tax Credit Program to physicians who practice in rural areas, would increase the overall financial incentive package that Maine could offer to attract physicians. The state should not consider a community-state matching programs, yet could consider working with rural hospital networks to set up residency programs that directly train physician to practice in Maine’s rural and underserved areas. The state needs to continue targeting medical students who have rural backgrounds and strong ties to the state – the Maine Health Professions Loan Program, and the Doctor for Maine Future Scholarship already list this as a core criteria of each of the programs. And lastly, with 40% of physicians seeking financial incentive programs post residency to assist them in paying their school debt, it’s imperative that Maine provide a competitive financial incentive program for primary care physicians.



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