INDUSTRY WATCH
Recruitment and retention challenges appear to continue almost unabated across the healthcare landscape, particularly when it comes to the specialist medical workforce in regional and rural areas of Australia.
Our AIHE Industry Watch considers the research findings from the recent McKinsey survey of the American medical practitioner workforce, to extrapolate & understand any common factors that may also be impacting medical practitioner retention efforts in Australia.
Whilst remuneration is a common factor for why any workforce may decide to shift roles and organisations, 69% of medical practitioners cite it as a main factor that have influenced their decision to leave their roles.
This is relevant to Australia particularly since achieving alignment between Medical Practitioner Awards & remuneration levels across the different jurisdictions still continue to be a significant hurdle.
When asked about factors that influence their decision to leave, apart from family needs & higher remuneration, well-being factors, such as the demanding nature, emotional toll, and physical toll of work (66 percent, 65 percent, and 61 percent, respectively), have also been found to be key determinants.
Not surprisingly, another key influence on medical practitioners’ decisions to leave, according to the survey survey, have been whether they are involved in decision making of the organisation and whether they have sufficient staffing support. .
It would be prudent for Australian health services to consider and address these findings within our own medical workforce strategic planning processes. Given the recruitment of medical practitioners into regional and rural areas continue to be a particular challenge for Australia, healthcare leaders must take a renewed interest in our retention efforts in particular, to consider innovative and out of the box strategies if we are to ensure the sustainability of the medical workforce across our health services.
To understand your role in medical workforce planning and clinical service planning for the Australian context, register for our new Essentials & Bespoke CPD programs, available now at aihexec.com/events.
Adapting successful international models of care to address Australia’s current health system challenges is the future of innovative healthcare leadership.
The RACE (Rapid Access to Consultative Expertise) program in Canada, is an innovative model of shared care where family physicians and nurse practitioners can call one telephone number and choose from a selection of specialty services for real-time advice.
The call is routed directly to the specialist’s cell phone or pager for “just in time” advice. This allows care planning decisions to be made for most patients when they’re at their primary healthcare provider appointments instead of having to wait to see a specialist.
Drawing from the model’s success overseas, Western Australia is set to fund a $8.2 million ‘GP ASK’ pilot program to enable GPs direct access to non-GP specialists, on their patients’ management and health issues, via phone or secure message. Patient records will be securely shared via WA’s Smart Referrals electronic referrals system.
Potential specialties from which GPs will be able to access advice in the pilot include:
Immunology
Paediatrics
Respiratory medicine
Spinal surgery
Geriatrics.
The 5 year operational review into Victoria’s VAD Legislation has found that between 2019 and 2023, 1,527 VAD permits were issued. Of those, 912 people (60%) opted to use the VAD substance, while 400 others had it dispensed but didn’t use it.
99.3% compliance over the four years was observed, with just 14 cases of non-compliance, half of which involved relatives not returning the VAD substance within the required 15 days. No instances of misuse were reported.
The review made several recommendations all of which have been accepted and are expected to be proposed for legislative amendment.
The full review report can be accessed via the Victorian Department of Health
For the first time in 5 years, while the proportion of people seen ‘on time’ in emergency departments has slightly improved compared to the previous year, the time in which 90% of people were seen, has become longer.
Across 2023–24, we note that:
The proportion of people ‘seen on time’ was 67%, up from 65% in 2022–23 and down from 74% in 2019–20.
50% of ED presentations were completed within 3 hrs 42 min, which is 46 min longer than in previous years.
90% of patients presenting to ED were waiting up 10 hrs 45min, which is more than 3 hrs longer than they were in previous years.
Of the patients who were subsequently admitted to the same hospital, 90% had waited upto 18hr 18min in the ED, whilst those subsequently not admitted had waited up to 7 hr 28 min.
Of the patients who were subsequently admitted to the same hospital, 50% had waited upto 6hr 4min in the ED, whilst those subsequently not admitted had waited up to 3hr 5 min.
For patients who were subsequently admitted to the same hospital, only one-third (31%) of ED presentations had been completed within 4 hours.
For patients not subsequently admitted, two-thirds (65%) of ED presentations had been completed within 4 hours.
Australia’s health expenditure has been on a consistent growth trajectory over the past decade, reaching a substantial $252.5 billion in spending for the year 2022-23, representing 9.9% of the GDP. However, recent data from the Australian Bureau of Statistics indicates a notable shift in health spending patterns over the last two years, showing a return to pre-pandemic trends.
As our healthcare landscape continues to evolve, with a pressing demand for increased funding in hospital and primary care services, health leaders in 2025 face the challenge of delivering safe, high-quality care with measurable outcomes that accurately reflect the costs of healthcare provision and community services.
Hospital admission and elective surgery waiting list data from Victorian public and private hospitals from 2014-2018, has found that 1% increase in private health insurance coverage is associated with about 0.34 days (0.5%) reduction on average in public hospital waiting times.
According to the research conducted by Ou Yang et al, whilst the effects varied by surgical speciality and age demographics, the small impact has been found to be of no practical significance to justify continued funding of the private health sector in the hope that it alleviates pressure on the public system.
New research shows that organisations with strong triad leadership teams are better equipped to successfully manage the clinical and operational complexities of healthcare (1).
The triad leadership model, characterised by collaboration among the Chief Medical Officer (CMO), Chief Nursing Officer (CNO), and Chief Operating Officer (COO), is gaining traction as a new method for optimising organisational performance in healthcare.
Recognising the need for an integrated approach to leadership, this structure leverages the distinct C-suite expertise of medical, nursing and operational executives.
Case study
An acute hospital successfully leveraged triad leadership to reduce Central Line-Associated Blood Stream (CLABSI) Infections(2).
The facility’s COO, realising the significant impact of CLABSI rates on quality and financial outcomes, ensured the appropriate resourcing from an operational, financial, and human resource perspective. The CMO ensured that evidence-based medicine protocols were being followed and engaged in collaborative discussions with the medical staff. The CNO ensured daily infection control audits, conducted daily assessments with clinicians on the necessity for central lines, and completed a central line checklist at the time of insertion to monitor for sterility.
Having this integrated approach to interventions, the hospital’s focus was on expediting removal of unneeded central lines, limiting the use of temporary central lines, complying with best practice insertion techniques, strengthening central line maintenance, and promoting triad stewardship.
Results
A review of risk-adjusted data demonstrated the hospital had five CLABSI events in 2018, four in 2019, zero in 2020 and one CLABSI event in 2021(2).
“We all exist on a continuum of inspiring to infuriating. This means that we aren’t born inspiring. Instead, it is our current behaviour that inspires or infuriates. The good news is we can become more inspiring just by putting these three universal qualities into practice.” according to Professor Galinsky.