Interventions for health workforce retention in rural and remote areas: a systematic review

This article provides useful information for rural and remote communities to understand what works and what doesn’t in the recruitment and retention of rural and remote GPs. There are numerous programs in Australia that are purportedly intended to grow the rural medical workforce, some of which have no evidence to support them such as the Bonded Medical Places program. The article suggests a number of strategies including:

Recruiting students to medical education from rural and remote communities (as opposed to regional and metropolitan cities) was significantly associated with working rurally, particularly if the students also trained in rural and remote areas.
There was no conclusive evidence that bonding students to work in rural areas in return for fee waivers or scholarships resulted in improved recruitment or retention.
Australian Government Rural Incentive Program payments were more effective in recruiting new GPs to incentivised rural areas rather than increasing the retention of existing GPs.
NSW GPs who were Visiting Medical Officers (and thereby received payments from the NSW Government in addition to income they receive from Medicare in general practice), had a 50% lower risk of leaving rural communities compared to GPs who were not.
Attracting other health workers to live and work in rural and remote towns was associated with an increase in doctors leaving rural towns because these practitioners were viewed to be competing with doctors for patients, reducing the financial viability of rural practice.
Providing GPs with access to a locum for a minimum period of 6 weeks every 12 months to allow GPs to have a holiday was strongly associated with retention.
Providing GPs with access to paid continuing professional development, with provision for back-filling their position for up to a year, was significantly associated with retention in rural areas.
There was little evidence to show providing rural doctors with access to a professional support network improved retention.
Access to educational opportunities for the children of rural GPs was strongly associated with retention.