The work motivations of the health practitioner who stays for a substantial time in the very remote Indigenous community workplace

Abstract

Objective: The aim of this study was to establish the nature of health practitioner (HP) motivations that are associated with the practitioner who chooses and stays in work in a very remote Indigenous (VRI) community for more than 3 years. The maldistribution of HPs across Australia and the high costs associated with their low retention rates in VRI communities underpinned the study. Little work had been conducted on the HP's intrinsic motivations relating to this workplace. The power of job-based incentives to attract and hold practitioners in remote and very remote areas has received some attention. It was hypothesised that the practitioner who chooses VRI community work will provide some motivation ratings very specific to that decision, which will be useful in predicting substantial total length of stay. Method: A total of 547 HPs from four levels of remoteness in Australia responded to a HP's motivation survey. Using principal component analysis, motivation components were identified. Using binary logistic regression, likelihoods were estimated, linking motivations with VRI community work retention. Results: Eight of 14 subscales developed were sensitive to VRI work experience. These formed the Very Remote Health Practitioner Motivation subscale set. Four of these motivation subscale scores together provided a significant estimate of likelihood of a practitioner having a total of more than 3 years' VRI community work experience, compared with no such experience. Conclusions: The aims of the study were achieved by identifying the eight subscale set and the retention predictive model. Their potential value, limitations of the study, and future research possibilities are discussed.