Money not enough to entice doctors to the bush

Researchers are interested in the factors that lead to GPs choosing one location over another. Brian Yap

Getting city doctors to move to rural areas for work would require a salary increase of up to $200,000 according to a University of Melbourne study, but even this level of financial incentive is not enough to deliver more rural doctors, experts say.

The study, entitled Getting Doctors into the Bush: GP’s Preferences for Rural Location, investigated the incentives and compensation (both financial and non-financial) to entice GPs to shift to rural locations.

“The main motivation behind this study is to look at the maldistribution of doctors across Australia, since we know that in rural areas it’s often difficult to get GPs into different locations,” said co-author of the report Associate Professor Guyonne Kalb, who is Director of Melbourne University’s Labour Economics and Social Policy Program.

The report comes as a Senate inquiry is investigating how existing incentive programs affect the recruitment and retention of country doctors.

“We were interested in what factors influenced the decision of doctors to go to one place over another, and I think having evidence on what factors are the most important will help design policies that are effective and will actually work,” Associate Professor Kalb said.

As part of the study nearly 4,000 GPs were asked to choose between their current employment and two hypothetical job offers. The fictitious jobs included various working hours, town size and locations, overtime responsibilities, general staffing levels and levels of likely social interaction. Sixty five per cent of respondents said they wouldn’t quit their current position for any of the country jobs, and depending on the circumstances of the new job, those that would move would expect between $16,000 and $200,000 in additional financial compensation.

But John Dwyer, who has been working with Charles Sturt University to help prepare a case for a rural medical school based in Orange, said doctors that seek additional financial compensation don’t really want to move to the country because they’re not from the country.

“At the moment the average rural GP earns considerably more than the average city MP so it’s not the lack of money or earning capacity that’s the problem, in fact they’d rather earn less and not have to work so hard,” Professor Dwyer said.

Associate Professor Kalb said doctors are very similar to other people in that they need some balance in various factors in their life.

“It’s about having time off your work – locums are really important for doctors to be able to get away and not feel like they have to be there. In rural areas that’s particularly important because there might not be any other doctors in the area, so that becomes a larger burden in a way,” Associate Professor Kalb said.

Professor Dwyer said many rural GPs have told him they feel totally isolated and they find it difficult to keep up to date, but he believes a hub and spoke model, taking advantage of teaching hospitals, could help.

“There is an enormous opportunity with the rollout of the national broadband network to set up a hub and spoke model, with a hub being a teaching medical school, you could have all your teaching practices scattered around in small towns hooked through the NBN to the hub at the university which would give help with continuing education, quality control.

"Fundamentally the happy, successful rural GP is one who actually loves country life, and their wife and kids like country life, and the way you get more of those is to take those people who have that strong affiliation and get them into medical school,” Professor Dwyer said.

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