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Financial incentives not effective in tackling rural GP shortages
A new study has found non-financial factors to be more important when determining where to live and work.
Money isn’t everything when it comes to determining where to live and work, as a new study finds.
There has long been a persistent shortage of GPs in rural, remote and even outer-suburban Australia. How to effectively address the issue remains a key question.
In an effort to counter the ongoing shortage, local health authorities regularly offer huge financial incentives, including overall packages as high as $500,000.
But these incentives often do not work. The question is – why?
A new Human Resources for Health paper may have part of the answer: work–life balance.
In short, GPs are less willing to relocate for financial incentives than authorities expect, with hours worked, on-call times and patient mix also playing an important role.
Health economists have often assumed that financial enticements would help distribute newly trained doctors into underserved areas. But the new paper, authored by World Health Organization (WHO) economist Dr Michelle McIsaac, questions that assumption, finding financial incentives are ‘not very effective’ at getting established GPs to relocate.
The paper states that GPs practising in low-socioeconomic areas in Australia face higher levels of demand, have less time, see patients with more comorbidities, and experience greater levels of stress than those practising in high-socioeconomic areas.
‘[F]inancial considerations are part of a larger number of factors influencing location choice. For instance, practice ownership played almost as important a role in mobility as earnings,’ the paper states.
‘Previous policy simulations suggest financial incentives aimed at locating new doctors in specific areas could be an effective policy lever. This paper finds that established GPs are not very mobile, even when a financial incentive is offered.
‘[F]inancial incentives, which are being used widely, may have limited effectiveness in inducing GPs to relocate once they have made an initial location choice. This seems to be reflected by the current geographic distribution of physicians, even with financial incentive programmes being adopted by many countries.’
Using the Medicine in Australia: Balancing Employment and Life (MABEL) survey of around 10,000 doctors, the study predicts that if GPs were given a 10% increase in earnings to move to a low-socioeconomic area, or remain if already living there, only 0.8% would be influenced.
The paper raises questions for incentive-based programs tackling GP workforce shortages.
‘Financial incentives to influence the recruitment and retention of health workers to underserved areas are becoming a widespread policy option; however, clear evidence of their effectiveness is lacking,’ the paper states.
incentives rural health workforce shortage
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