Raising the retention rate of practitioners in rural areas


Acknowledging the challenges faced by health practices and physiotherapy professionals in rural areas is the key to providing useful strategies in confronting the staff retention rates in these communities.

Some of the most common complaints by practitioners working  in rural areas are; a shortage of opportunities for career progression, professional support, access to professional development opportunities (including postgraduate education)  and a resounding feeling of not being valued as either an  employee or a practitioner.

A tool for understanding these issues is Frederick Herzberg’s theory of intrinsic and extrinsic motivation. This theory divides the factors that influence employee satisfaction into two distinct categories— intrinsic and extrinsic motivators.

Intrinsic—having a sense of fulfilment about professional abilities and personal goals met in the workplace.

Extrinsic—incentives provided by the workplace like staff benefits or a good salary.

Extrinsic factors are often referred to in management circles as ‘hygiene factors’. They are a foundation in avoiding employee dissatisfaction. The presence of extrinsic factors, in theory, increases a staff member’s job satisfaction—however, this won’t necessarily create job satisfaction. It’s a perk, not a miracle.

An Australian study found the three most commonly reported contributors to job satisfaction for allied health professionals working in rural communities were; diverse caseloads, autonomy of practice, and a feeling of being valued by patients and co-workers.

New graduates reported that seeking employment in rural areas is a good idea for the first few years in the workforce—as they are generally exposed to diverse caseloads and given levels of autonomy higher than their metropolitan counterparts. This autonomy and relative lack of supervision facilitates rapid skill development that is far less accessible in urban settings.

However, this limits the assistance available for complex cases and can lead to a feeling of professional isolation. This leads to employment in rural communities being a temporary fixture in  the lives of these practitioners—who then leverage the experience they gained to obtain ‘better’ employment opportunities in metropolitan areas.

To combat this fleeting attraction to rural employment in physiotherapists, we must first highlight the importance of professional support. Providing access to adequate resources (human or otherwise) should be a key focus of a business. Employees derive motivation from the challenges of their work, however, being overwhelmed is often caused by feeling unsupported.

While a lack of recognition in the wider community may appear outside of your control, finding solutions to increase public knowledge may be simpler than you imagine.

Partnering with other local businesses to organise a community event can increase business visibility and give locals a chance to get to know you and your employees. The resulting improvements in community perception of the profession may lead to increased feelings of appreciation among your staff.

Having an external consultant visit the practice, arranging regular CPD opportunities, and providing access to telehealth services are steps that can be taken to demonstrate a commitment to providing professional support.

Implementing bonus schemes for attaining and exceeding patient targets can act as a strong incentive to improve retention. Offering competitive salaries can be difficult in environments where business income fluctuates. Aligning higher earnings with higher patient loads is incentive for  staff to work harder, knowing they will reap the rewards when they succeed.

This article presents some strategies to alleviate the dissatisfaction reported by employees in rural areas, however overcoming the challenge of recruitment and retention in  rural settings will require a coordinated approach with input from staff, business owners and members of the wider community alike.

 >> Wentworth Advantage operates the HR in Practice workplace relations advisory service for APA Business Group members. If you have any questions about  this article, contact the HR in Practice service on hrinpractice@australian.physio. For more information on the benefits of joining the Business Group, email info@australian.physio or call  1300 306 622. 

Disclaimer: The material contained in this publication is general comment and is not intended as advice on any particular matter, nor should it be relied on as a substitute for legal or professional advice. Wentworth Advantage Pty Ltd expressly disclaim all and any liability to any persons whatsoever in respect of anything done or omitted to be done by any such person in reliance whether in whole or in part upon any of the contents of this publication.


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