A detailed study of 3,906 GPs – nearly one-in-five of the national GP workforce – has revealed that small-sized towns face the highest risk of GP turnover, with key influencing factors being GPs working in a location for less than three years, being contracted or salaried employees, or international medical graduates.
While remote and very remote GPs had the highest mobility rate, this group was not at significantly greater risk of leaving non-metropolitan practice completely. Rural GPs practising in towns of less than 5,000 residents, and in towns of up to 15,000 residents, were most likely to move to metropolitan areas.
Overall, annual location retention rates were 95 per cent in regional centres, 90 per cent in small rural towns, and 82 per cent in very remote areas.
The four-year study drew on data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, conducted within the Centre for Research Excellence in Medical Workforce Dynamics. MABEL is Australia's national longitudinal survey of doctors, and collects similar data in annual waves from mostly the same panel of doctors.
Geographical mobility of general practitioners in rural Australia was reported in the Medical Journal of Australia by Matthew R McGrail and John S Humphreys.
The authors regard GPs as “Key to improving the poorer health status that characterises people in rural areas [and to] ensuring equitable access to appropriate health care… this requires recruiting and retaining an adequate supply of appropriate health workers, which is known to be difficult in rural and remote areas.”
The younger age of GPs was found to be “a small predictor of increased mobility” while sex and family status were found not to be a factor.
The Monash University-based authors said that while the chance of moving to a non-metropolitan area was 1 in 75 for metropolitan GPs, the risk of losing non-metropolitan GPs to metropolitan areas was 1 in 31.
“Of the 271 GPs who moved within non-metropolitan Australia, 77 moved to regional centres (population over 50,000), but only 24 left regional centres for a smaller rural or remote location. A further 18 GPs moved from a rural to a remote location and 35 moved from remote practice to small or large rural locations.
“Understanding GP mobility is important because of its impact on workforce availability — both in the origin area (place from which the doctor moved) and the destination area,” they said.
“Considerable investment is made by governments into health programs specifically oriented towards improving the recruitment and retention of doctors in rural areas, with the goal of maximising movement into and minimising movement away from rural areas,” they added.