Australian journal of primary health
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Opioid substitution therapy (OST) is a well-recognised, evidence-based treatment for opioid dependence. Since the early 1990s, Australia has used a community-based general practitioner (GP) model ofprescribing, particularly within the state of Victoria, where over 85% of OST prescribing is undertaken by GPs in community settings. Yet the majority of GPs invited to complete the required OST training decline the offer, while of those who complete training, the majority prescribe to few or no patients. ⋯ General practitioners who became regular prescribers were highly committed with lengthy general practice experience. Concerns exist about the recruitment process for OST prescriber training, where nearly all GPs decline the offer of training, and the barriers that prevent GPs prescribing after training. Action is needed to address barriers to GP OST training and prescribing, and further research is necessary to ascertain measures required to facilitate long-term prescribing.
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The objectives of this study were to measure the relative strength, significance and contribution of factors associated with rural and remote medical workforce retention. Length of stay data from two Australian GP workforce datasets, the 2008 National Minimum Data Set (4223 GPs) and a subset of the 2008 Medicine in Australia: Balancing Employment and Life dataset (1189 GPs), were separately analysed using multiple linear regression models and the results compared. Length of employment in their current practice location was the outcome measure. ⋯ Less important factors included geographic location, procedural skills, annual leave, workload and practice size. Our findings quantify a range of financial and economic, professional and organisational, and geographic factors contributing to the retention of rural GPs. These findings have important implications for future medical workforce policy, providing an empirical evidence base to support the targeting and 'bundling' of retention initiatives in order to optimise the retention of rural GPs.