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Community Apgar Program

A Tool for Improving the Recruitment and Retention of Critical Access Hospital and Community Health Center Physicians

Community factors play a key role in the recruitment and retention of physicians to rural and underserved healthcare settings.  The Community Apgar Program (CAP) developed by researchers, educators and clinicians at Boise State University and the Family Medicine Residency of Idaho helps to organize these community factors for action.

The goals of the CAP are to:

  1. Identify individual community strengths and unique opportunities for improvement in Critical Access Hospitals (CAHs) and Community Health Centers (CHCs) related to recruiting and retaining physicians.
  2. Understand state or regional patterns impacting physician supply which can be addressed at the macro level.
  3. Create a shared national database to facilitate broader understanding of important issues related to physician recruitment and retention to rural and underserved areas.

The CAP provides individualized information for specific CAH and CHC improvement strategies.  The states of Idaho, Wyoming, North Dakota, Wisconsin, Alaska, Indiana, Utah and Montana are currently participating in the CAH CAP while the states of Idaho and Maine are currently participating in the CHC CAP.    In addition, several other states have shown interest in implementing this innovative community assessment tool (see map to the right).

What CAHs and CHCs will gain with involvement in the CAP:

  • Receive an analysis of specific comparative strengths and challenges that your communities face, providing results in actionable plans for recruiting and retaining physicians.
  • Obtain information that you may utilize for addressing state-specific issues as well as to establish a platform that is evidence based for the advocacy of those issues.
  • Participants in the CAP join a national database sharing trends and patterns to identify opportunities to improve physician workforce challenges.
  • Develop and participate in the ‘best practices’ across your community networks.

The Community Apgar Questionnaire (CAQ) assesses a community’s capability to recruit and retain physicians.  The CAQ consists of questions incorporated into five classes; each class contains 10 factors, for a total of 50 factors/questions representing specific elements related to recruitment and retention of physicians.  The CAP utilizes the results compiled over a two year period to provide a real time assessment of a community’s ability to develop and execute action plans for improvement.

We have a lot to offer that we are not taking advantage of.

Rick Schroeder, CEO of North Bighorn Hospital, Wyoming

To find out more information please contact:

Dr. Ed Baker at 208-426-3118 or

Dr. David Schmitz at 208-367-6824