Trials and tribulations of country doctors: A qualitative study of doctor-patient relationships in rural Israel

Rural areas of Israel are organized into small villages that attract physicians by offering inexpensive accommodation and the promise of a high quality of life. However, conflicts often arise in the relationship between the village residents and the doctor, leading to dissatisfaction and physician turnover. In order to examine the issues, we conducted a qualitative study of rural physicians using a group interviewing technique, called focus groups. The sample consisted of 46 physicians, aged between 35 and 45, of whom 60% were male. In the focus groups, the physicians mainly discussed issues of unclear boundaries between private life and physician roles, exaggerated expectations on the part of community members, difficulties with teamwork, the impact on the physician's family, work satisfaction, and burnout. Recommendations for physicians considering rural practice include making a careful and studied choice of a village before making a final decision, setting both clear professional limits and an overall time limit for service, allowing for mistakes, and organizing Balint-type physician support groups.