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Human Resources for Health
Published in: Human Resources for Health 1/2017

Open Access 01-12-2017 | Research

Family effects on the rurality of GP’s work location: a longitudinal panel study

Authors: Matthew R. McGrail, Deborah J. Russell, Belinda G. O’Sullivan

Published in: Human Resources for Health | Issue 1/2017

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Abstract

Background

Reduced opportunities for children’s schooling and spouse’s/partner’s employment are identified internationally as key barriers to general practitioners (GPs) working rurally. This paper aims to measure longitudinal associations between the rurality of GP work location and having (i) school-aged children and (ii) a spouse/partner in the workforce.

Methods

Participants included 4377 GPs responding to at least two consecutive annual surveys of the Medicine in Australia: Balancing Employment and Life (MABEL) national longitudinal study between 2008 and 2014. The main outcome, GP work location, was categorised by remoteness and population size. Five sequential binary school-age groupings were defined according to whether a GP had no children, only preschool children (aged 0–4 years), at least one primary-school child (aged 5–11 years), at least one child in secondary school (aged 12–18 years), and all children older than secondary school (aged ≥ 19). Partner in the workforce was defined by whether a GP had a partner who was either currently working or looking for work, or not. Separate generalised estimating equation models, which aggregated consecutive annual observations per GP, tested associations between work location and (i) educational stages and (ii) partner employment, after adjusting for key covariates.

Results

Male GPs with children in secondary school were significantly less likely to work rurally (inclusive of > 50 000 regional centres through to the smallest rural towns of < 5000) compared to male GPs with children in primary school. In contrast, female GPs’ locations were not significantly associated with the educational stage of their children. Having a partner in the workforce was not associated with work location for male GPs, whereas female GPs with a partner in the workforce were significantly less likely to work in smaller rural/remote communities (< 15 000 population).

Conclusions

This is the first systematic, national-level longitudinal study showing that GP work location is related to key family needs which differ according to GP gender and educational stages of children. Such non-professional factors are likely to be dynamic across the GP’s lifespan and should be regularly reviewed as part of GP retention planning. This research supports investment in regional development for strong local secondary school and partner employment opportunities.
Literature
1.
McGrail MR, Russell DJ. Australia’s rural medical workforce: supply from its medical schools against career stage, gender and rural-origin. Aust J Rural Health. 2016; doi:10.​1111/​ajr.​12323.
2.
Strasser R, Kam S, Regalado S. Rural health care access and policy in developing countries. Annu Rev Public Health. 2016;37:395–412.CrossRefPubMed
3.
Weinhold I, Gurtner S. Understanding shortages of sufficient health care in rural areas. Health Policy. 2014;118:201–14.CrossRefPubMed
4.
5.
Dussault G, Franceschini MC. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Hum Resour Health. 2006;4:12.CrossRefPubMedPubMedCentral
6.
Dolea C, Stormont L, Braichet J-M. Evaluated strategies to increase attraction and retention of health workers in remote and rural areas. Bull World Health Organ. 2010;88:379–85.CrossRefPubMedPubMedCentral
7.
Budhathoki S, Zwanikken P, Pokharel P, Scherpbier A. Factors influencing medical students’ motivation to practise in rural areas in low-income and middle-income countries: a systematic review. BMJ Open. 2017;7:e013501.CrossRefPubMedPubMedCentral
8.
Grobler L, Marais B, Mabunda S. Interventions for increasing the proportion of health professionals practising in rural and other underserved areas. Cochrane Database Syst Rev. 2015;2015(6):CD005314.
9.
Wilson N, Couper I, De Vries E, Reid S, Fish T, Marais B. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural Remote Health. 2009;9:1060.PubMed
10.
World Health Organization. Increasing access to health workers in remote and rural locations through improved retention: global policy recommendations. Geneva: WHO Press; 2010.
11.
Humphreys JS, McGrail MR, Joyce CM, Scott A, Kalb G. Who should receive recruitment and retention incentives? Improved targeting of rural doctors using medical workforce data. Aust J Rural Health. 2012;20:3–10.CrossRefPubMed
12.
McGrail MR, Humphreys JS, Scott A, Joyce C, Kalb G. Professional satisfaction in general practice: does it vary by community size? Med J Aust. 2010;193:94–8.PubMed
13.
Hays R, Wynd S, Veitch C, Crossland L. Getting the balance right? GPs who chose to stay in rural practice. Aust J Rural Health. 2003;11:193–8.CrossRefPubMed
14.
Laurence CO, Williamson V, Sumner KE, Fleming J. “Latte rural”: the tangible and intangible factors important in the choice of a rural practice by recent GP graduates. Rural Remote Health. 2010;10:1316.PubMed
15.
Mayo E, Mathews M. Spousal perspectives on factors influencing recruitment and retention of rural family physicians. Can J Rural Med. 2006;11:271–6.PubMed
16.
Viscomi M, Larkins S, Sen Gupta T. Recruitment and retention of general practitioners in rural Canada and Australia a review of the literature. Can J Rural Med. 2013;18:13–23.PubMed
17.
Ellsbury KE, Baldwin L-M, Johnson KE, Runyan SJ, Hart L. Gender-related factors in the recruitment of physicians to the rural northwest. J Am Board Fam Med. 2002;15:391–400.
18.
Mathews M, Seguin M, Chowdhury N, Card R. Generational differences in factors influencing physicians to choose a work location. Rural Remote Health. 2012;12:1864.PubMed
19.
Yang J. Potential urban-to-rural physician migration: the limited role of financial incentives. Can J Rural Med. 2003;8:101–6.
20.
Humphreys JS, Jones JA, Jones MP, Hugo G, Bamford E, Taylor D. A critical review of rural medical workforce retention in Australia. Aust Health Rev. 2001;24:91–102.CrossRefPubMed
21.
Henry JA, Edwards BJ, Crotty B. Why do medical graduates choose rural careers? Rural Remote Health. 2009;9:1083.PubMed
22.
23.
Australian Curriculum Assessment and Reporting Authority. NAPLAN achievement in reading, writing, language conventions and numeracy: national report for 2016. Sydney: ACARA; 2016.
24.
Downes N, Roberts P. Revisiting the schoolhouse: a literature review on staffing rural, remote and isolated schools in Australia 2004–2016. Aust Int J Rural Educ. 2018;28:31–54.
25.
Lyons T, Cooksey R, Panizzon D, Parnell A, Pegg J. Science, ICT and mathematics education in rural and regional Australia: the SiMERR national survey abridged report of findings: University of New England. Armidale: National Centre of Science, ICT and Mathematics Education for Rural and Regional Australia; 2006.
26.
27.
Rodriguez-Pose A, Hardy D. Addressing poverty and inequality in the rural economy from a global perspective. Appl Geogr. 2015;61:11–23.CrossRef
28.
Australian Bureau of Statistics. Regional population growth: population estimates by remoteness area, 2005 to 2015. Canberra: ABS; 2016.
29.
United Nations. Department of Economic and Social Affairs. Population Division. World urbanization prospects: the 2014 revision, highlights. New York: United Nations; 2014. ST/ESA/SER.A/352
30.
Cooke TJ. Metropolitan growth and the mobility and immobility of skilled and creative couples across the life course. Urban Geography. 2014;35:219–35.CrossRef
31.
McGrail MR, Russell D, Campbell D. Vocational training of general practitioners in rural locations is critical for Australian rural medical workforce supply. Med J Aust. 2016;205:216–21.CrossRefPubMed
32.
Benson M. The context and trajectory of lifestyle migration. Eur Soc. 2010;12:45–64.CrossRef
33.
von Reichert C, Cromartie JB, Arthun RO. Impacts of return migration on rural U.S. communities. Rural Sociol. 2014;79:200–26.CrossRef
34.
Humphreys JS, Rolley F. A modified framework for rural general practice: the importance of recruitment and retention. Soc Sci Med. 1998;46:939–45.CrossRefPubMed
35.
Somers G, Jolly B, Strasser R. The SOMERS index: a simple instrument designed to predict the likelihood of rural career choice. Aust J Rural Health. 2011;19:75–80.CrossRefPubMed
36.
Joyce C, Scott A, Jeon S, Humphreys JS, Kalb G, Witt J, Leahy A. The “Medicine in Australia: Balancing Employment and Life (MABEL)” longitudinal survey—protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res. 2010;10:50.CrossRefPubMedPubMedCentral
37.
38.
McGrail MR, Humphreys JS, Joyce CM. Nature of association between rural background and practice location: a comparison of general practitioners and specialists. BMC Health Serv Res. 2011;11:63.CrossRefPubMedPubMedCentral
39.
McGrail MR, Humphreys JS, Joyce CM, Scott A. International medical graduates mandated to practise in rural Australia are highly unsatisfied: results from a national survey of doctors. Health Policy. 2012;108:133–9.CrossRefPubMed
40.
McGrail MR, Wingrove PM, Petterson SM, Bazemore AW. Mobility of United States rural primary care physicians from 2000–2014. Ann Fam Med. 2017;15:322–8.CrossRefPubMed
41.
Myroniuk L, Adamiak P, Bajaj S, Myhre D. Recruitment and retention of physicians in rural Alberta: the spousal perspective. Rural Remote Health. 2016;16:3620.PubMed
42.
43.
Sorenson O, Dahl MS. Geography, joint choices, and the reproduction of gender inequality. Am Sociol Rev. 2016;81:900–20.CrossRef
44.
Bielby WT, Bielby DD. I will follow him: family ties, gender-role beliefs, and reluctance to relocate for a better job. Am J Sociol. 1992;97:1241–67.CrossRef
45.
Terry D, Baker E, Schmitz D. Community assets and capabilities to recruit and retain GPs: the Community Apgar Questionnaire in rural Victoria. Rural Remote Health. 2016;16:3990.PubMed
46.
47.
Buykx P, Humphreys JS, Wakerman J, Pashen D. Systematic review of effective retention incentives for health workers in rural and remote areas: towards evidence-based policy. Aust J Rural Health. 2010;18:102–9.CrossRefPubMed
48.
Kroezen M, Dussault G, Craveiro I, Dieleman M, Jansen C, Buchan J, Barriball L, Rafferty A, Bremner J, Sermeus W. Recruitment and retention of health professionals across Europe: a literature review and multiple case study research. Health Policy. 2015;119:1517–28.CrossRefPubMed
49.
Li J, Scott A, McGrail MR, Humphreys JS, Witt J. Retaining rural doctors: doctors’ preferences for rural medical workforce incentives. Soc Sci Med. 2014;121:56–64.CrossRefPubMed
50.
51.
52.
53.
Argent N, Tonts M, Jones R, Holmes J. The amenity principle, internal migration, and rural development in Australia. Ann Assoc Am Geogr. 2014;104:305–18.CrossRef
54.
55.
56.
Hancock C, Steinbach A, Nesbitt T, Adler S, Auerswald C. Why doctors choose small towns: a developmental model of rural physician recruitment and retention. Soc Sci Med. 2009;69:1368–76.CrossRefPubMed
Metadata
Title
Family effects on the rurality of GP’s work location: a longitudinal panel study
Authors
Matthew R. McGrail
Deborah J. Russell
Belinda G. O’Sullivan
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2017
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-017-0250-z

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