The effects of precepting on and the support desired by community-based preceptors in Iowa

To survey community-based family physician-preceptors about teaching costs, issues, and support desired. In late 1994 a questionnaire was mailed to all 139 community family physicians who served as preceptors for the University of Iowa College of Medicine's third-year family practice preceptorship. The questionnaire contained items regarding teaching costs and the kinds of assistance desired from the university, the difficult and enjoyable aspects of precepting, and demographic data. Analyses were done to explore the associations between the preceptors' demographic variables and the effects of precepting on number of patients seen, practice income, and time spent at work. Also tested were the associations between the demographic variables and the kinds of support desired. In all, 130 surveys were returned, for a response rate of 94%. Nearly all of the respondents were Caucasian, male, and residency trained; 61% were in group practices. While precepting, 87% spent more time at work, 31% saw fewer patients, and 25% lost practice income; mean daily cost estimates of precepting were 51 more minutes at work, 1.4 fewer patients seen, and $34 in lost income. The support the preceptors were most interested in receiving was training in and access to computer-based information. Financial compensation was desired more often by the physicians whose first year of practice was after 1977 (p = .009). Motivations for precepting included positive interactions with students and enjoyment of teaching. Time concerns were overwhelmingly the most difficult aspect of precepting. The physicians-many of whom noted their enjoyment of teaching for its intrinsic rewards-spent a significant amount of extra time teaching while precepting, and thus both lost income and saw fewer patients. Medical schools need to recognize the valuable contributions of preceptors and find ways to support them.