Flexibility was one of the main issues. Many participants said their work weeks varied, based on needs of patients, and many said they were understaffed—leading to lack of vacations. "Participants described an acceptance of this unpredictability, however, and a willingness to adapt to their changing circumstances,' the study reports. "They varied the time they gave to family and recreation based on professional demands. Supportive partners with flexible schedules often facilitated this acceptance."
"Many participants described the support of their life partners as essential for career success," the study reports. "Respondents often acknowledged that their partners had made sacrifices in order to live in rural areas. They emphasized that without those sacrifices, their chosen professions would not be possible. Some spouses had left more desirable employment to allow their partners to pursue rural practice. Respondents often described an understanding that their own careers took priority over those of their male partners. Many partners were self-employed or worked part-time Some had professional careers but worked remotely with urban colleagues. Other partners came from rural communities, had rural occupations (such as farming), and strongly desired rural life. The few participants whose partners would not, or could not, support the demands of their work planned to leave their positions in the near future."
Participants said one problem in rural communities is being approached by patients in public, or phoned at home by patients. While most participants said they set clear boundaries between work and personal time, "when conflicts arose between patient care and family needs, however, participants experienced distress. Although they acknowledged the importance of caring for themselves and their families, they felt guilty when they were not available for patients." One participant who was contemplating leaving her practice, said, “I just am not sure I can continue to deal with … situations where it’s on me to either make a decision about my child or my childcare or shutting down a clinic for a whole day and having patients be out of luck.”