Geographical mobility of general practitioners in rural Australia

Objective: To describe the geographical mobility of general practitioners in Australia, both within rural areas and between rural and metropolitan areas. Design and participants: Annual panel survey of GPs between 2008 and 2012. Main outcome measures: Work location, categorised by a typology based on geographical location and community size; frequency of mobility (change of location category); and characteristics of those who moved. Results: There were 3906 participants in 2008 (representative cohort, 19% of Australia's GP workforce) and 3502, 3514, 3287 and 3361 in subsequent years. 1810 GPs participated in all 5 years, and 10 900 origin-destination pairs were observed after removing GP registrars from the dataset. A total of 133 GPs moved from rural to metropolitan locations, 103 moved from metropolitan to rural locations, and 271 observed location changes were within rural areas. Annual location retention rates were 95% in regional centres, 90% in small rural towns and 82% in very remote areas. GPs in small towns of < 5000 residents had the highest risk of leaving rural practice. Mobility rates were significantly higher for GPs who had worked in a location for under 3 years and those working as either contracted or salaried employees, and somewhat higher for international medical graduates. Younger age was a small predictor of increased mobility, while sex and family status had no association with mobility. Conclusion: GPs working in small communities and those in a rural location for less than 3 years are most at risk of leaving rural practice.