Immersing doctors-in-training in rural experiences and enhancing rural generalist pathways, with greater government support for overburdened and isolated doctors in the bush are among key recommendations from a new paper on Australia’s rural doctor shortage.
The policy brief, Solving Australia’s Rural Medical Workforce Shortage, from the University of Melbourne’s Centre for Research Excellence in Medical Workforce Dynamics examines the evidence on effective strategies to attract doctors to regional and remote areas.
Rather than removing medical jobs from the Skilled Occupations list, as has recently been mooted by the Department of Health, researchers from the CRE recommend an evidence-based mix of measures to address the issue:
- select medical students with a rural background — increases the supply of rural GPs by a factor of 2.5 — and immerse undergraduates in rural experiences
- boost numbers of GPs and generalists overall to increase the pipeline of potential rural practitioners
- increase vocational training in rural areas, especially for GPs — results in subsequent rural practice that is sustained for at least five years
- ensure accessible locum support and ongoing professional development for rural doctors to improve retention rates, with a particular focus on advanced training opportunities that will benefit both practitioner and community
- hone financial incentives to specifically address a town’s population size, geographical remoteness and local needs
- development of regional specialist hubs with a focus on outreach to address gaps in service provision
- continue the 10-year moratorium and 457 visas as policy levers, but anticipate decreased reliance on these measures over time
“The hope is that increased numbers of locally-trained doctors will meet rural service demand,” said one of the paper’s authors, Professor Anthony Scott.
Of interest among the paper’s findings, which are drawn from the annual MABEL survey of around 10,000 doctors, 65% of GPs say they would not move location no matter the financial incentive.
To attract doctors to the most isolated, underserviced communities, the authors calculated that an incentive equivalent to 130% of current annual earnings would be required — some $240,000 per year.
Improving supply in these locations is likely to require higher incentives than those currently available, or changes to service delivery models to improve workload, on-call and availability of locums, or a combination of these strategies.
Psychiatry, endocrinology and paediatrics are among priority specialties identified as requiring particular attention for improved rural recruitment.
In addition, the authors suggest boosting subsidies and other measures to improve outreach services by metropolitan-based specialists to rural and remote areas.
We’d love to hear your thoughts on these and other strategies to address workforce issues in Australia’s regions.