Geographical mobility of general practitioners in rural Australia

Abstract

Objective: To describe the geographical mobility of general practitioners in Australia, both within rural areas and between rural and metropolitan areas. Design and participants: Annual panel survey of GPs between 2008 and 2012. Main outcome measures: Work location, categorised by a typology based on geographical location and community size; frequency of mobility (change of location category); and characteristics of those who moved. Results: There were 3906 participants in 2008 (representative cohort, 19% of Australia's GP workforce) and 3502, 3514, 3287 and 3361 in subsequent years. 1810 GPs participated in all 5 years, and 10 900 origin–destination pairs were observed after removing GP registrars from the dataset. A total of 133 GPs moved from rural to metropolitan locations, 103 moved from metropolitan to rural locations, and 271 observed location changes were within rural areas. Annual location retention rates were 95% in regional centres, 90% in small rural towns and 82% in very remote areas. GPs in small towns of < 5000 residents had the highest risk of leaving rural practice. Mobility rates were significantly higher for GPs who had worked in a location for under 3 years and those working as either contracted or salaried employees, and somewhat higher for international medical graduates. Younger age was a small predictor of increased mobility, while sex and family status had no association with mobility. Conclusion: GPs working in small communities and those in a rural location for less than 3 years are most at risk of leaving rural practice.

Glass half full: Survival analysis of new rural doctor retention in Western Australia

“…12 Similarly, we found that the majority of both newly recruited registrars (58% in 2009-2013) and non-registrars (51%) left the rural workforce within 3 years. 12 Similarly, we found that the majority of both newly recruited registrars (58% in 2009-2013) and non-registrars (51%) left the rural workforce within 3 years.…”

Determinants of rural Australian primary health care worker retention: A synthesis of key evidence and implications for policymaking

“…25 The eight studies used a range of different analytical methods. 6,23,26 Multiple factors, including some from each of the six broad domains of retention, were consistently found to be significantly associated with rural retention. 27,29 More sophisticated analytical approaches used regression models (including linear, logistic and Cox Proportional Hazards models) which adjusted for multiple factors at once.…”

“…Study sample sizes ranged from the relatively small study of 70 former Tasmanian GP Registrars 28 to 4223 Australian rural GPs. 6,[23][24][25][26]28 The highest quality studies were large and able to account for how long PHC workers had already been working in a rural location when assessing the risk of leaving. Several studies tested differences in proportions or differences in means without taking any potential confounders into account.…”

Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply

“…Increasingly too, graduates are choosing medical specialities over generalist roles, further compounding the difficulties in recruiting and retaining rural primary care doctors 4,5 . Nonetheless, professional satisfaction is often high amongst existing rural primary care doctors 6 , with many rural communities serviced by long-standing doctors 7,8 .…”