Retention of doctors in remote and small rural/rural isolated communities remains a challenge around the world. Given the inequities and health disparities in many of our remote communities, there is a social imperative to address this retention issue in light of the recognised benefits to community health of longitudinal care by well-trained family physicians.
The sites visited and doctors interviewed for this Churchill Fellowship in Canada demonstrated that vastly improved long term retention in remote areas is possible – both in Canada and in our very similar situations in Australia.
The recommendations to achieve this as outlined in this report should all be achievable within relatively short timeframes. Some of these will require increased funding but it is also clear that a strong economic argument can be made for this increased investment. Poor retention and high turnover of staff is costly not only to the patients, community and the doctors, but also to the system and governments. Recruitment and orientation has been shown to be costly, as is the reliance on locums. Better care in remote areas can also bring about considerable cost savings in the form of reduced medical evacuations.
Organisations such as NOSM are increasingly able to provide additional evidence of the economic benefits to communities and governments of retention of doctors, and attention should be given to their findings. In addition, there is the ethical and moral imperative to address health disparities in our most underserved communities. I recommend the findings of this report to Australian and Canadian provincial/state and federal governments, health services, recruitment officers, universities and training providers and medical management.
Keywords: Remote, rural retention, doctors, medical workforce, health
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