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'It's mostly about the job' - putting the lens on specialist rural retention

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Allen, P ORCID: 0000-0003-1945-8049, May, J, Pegram, R and Shires, L ORCID: 0000-0003-3396-7894 2020 , ''It's mostly about the job' - putting the lens on specialist rural retention' , Rural and Remote Health, vol. 20, no. 1 , doi: 10.22605/RRH5299.

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Abstract

Introduction: Rural health services throughout the world faceconsiderable challenges in the recruitment and retention ofmedical specialists. This research set out to describe the factorsthat contribute to specialist workforce retention and attrition in ahealth service in rural Tasmania, Australia.Methods: This qualitative study utilised in-depth interviews with22 medical specialists: 12 currently employed by the service and 10who had left or intended to leave. Interview transcripts werethematically analysed to identify professional, social and locationfactors influencing retention decision-making.Results: Professional and workplace factors were more importantthan social or location factors in retention decision-making.Tipping points were excessive workloads, particularly on-call work,difficult collegial relationships, conflict with management, offers ofmore appealing positions elsewhere, family pressure to live in ametropolitan area, educational opportunities for children and alack of contract flexibility. Inequitable workload distribution andthe absence of senior registrars contributed to burnout. Financialremuneration was not a primary factor in retention decisionmaking, however, there was acknowledgement of the need toensure equitable pay scales, flexible employment contractsincluding statewide positions and increased CPD payments/leave.Specialists who had autonomy in determining their preferred workbalance tended to stay, as did those who had family or developedsocial connections within the area, rural backgrounds and apreference for rural living.Conclusion: To improve specialist workforce retention, ruralhealth services should ensure a professionally rewarding,harmonious work environment, without onerous out-of-hoursdemands and where specialists feel valued. Specialists should haveautonomy over workloads, flexible contracts, appropriate financialremuneration and enhanced access to CPD. New specialists andtheir families should have additional support to assist with socialintegration.

Item Type: Article
Authors/Creators:Allen, P and May, J and Pegram, R and Shires, L
Keywords: medical specialists, workforce retention, rural health, Australia
Journal or Publication Title: Rural and Remote Health
Publisher: Deakin University
ISSN: 1445-6354
DOI / ID Number: 10.22605/RRH5299
Copyright Information:

Copyright 2020 the authors. This work is licensed under a Creative Commons Attribution 4.0 International Licence https://creativecommons.org/licenses/by/4.0/

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