“AGE, FRUSTRATION AND CALL” UNDERSTANDING INTENTIONS TO LEAVE THE NZ PUBLIC HEALTH WORKFORCE Charlotte Chambers, ASMS Principal Analyst cc@asms.nz

Introduction

Introduction Focus on Intentions to Leave (ITL)

The DHB-based senior medical workforce

The Senior Medical Workforce

Future work intentions of the DHB-based workforce To assess rates of intentions to change level of involvement in DHB-based employment within the next 5 years. To understand various push/pull factors that may shape these intentions. To examine associations between intentions and demographic factors: – FTE, age, gender, specialty, IMG, health status, job satisfaction. Scores of 4 or 5 signaling an intent to leave (Reverse scoring for scenario 2) The purpose of this survey is to provide the ASMS with insight into future work intentions of the DHB-based senior medical workforce. Future work intentions are defined broadly to include changes that may be sought in the course of individual’s DHB-work but have not yet been formalised. A core focus of this survey is on intentions to leave the DHB-based workforce as well as possible changes to hours of work as measured by FTE.   Specific aims include: To assess rates of intentions to change level of involvement in DHB-based employment for all ASMS members within the next 5 years To understand various push/pull factors that may shape these intentions To understand whether there are associations between these intentions and various demographic factors including: FTE, age, gender, medical specialty, international medical graduates, health status and job satisfaction.

Core questions: Over the next 5 years, how likely are you to: Leave medicine entirely Remain in DHB-based employment Leave NZ permanently to go overseas. Of those remaining, how would you like to change: FTE On-call.

Limitations of approach PROSPECTIVE STUDY!!! What people might like to do may not happen or may not be possible BUT intentions ARE strong predictor (Hann 2010) Identifying those at risk of leaving Understanding reasons WHY Interventional strategies

24%

Within the next 5 years, how likely are you to leave medicine entirely? The 16.2% corresponds to 387 individuals.

Within the next 5 years, how likely are you to continue with some form of DHB-based employment? The 5.4% corresponds to 108 individuals

Within the next five years, how likely are you to leave New Zealand to practise medicine abroad? The 4.2 % here corresponds to only 79 individuals.

Intention to leave medicine by DHB

Worst case scenario:

Worst case scenario: 24% may leave over next 5 years. Of the remaining 76%: ~ 40% may decrease FTE ~30% would like to decrease call/shift work ~8% would like to drop call entirely. Suggested exit rate does align with the MoH figures but the exit rates are higher than what we’ve seen in the previous 5 years.

Summary Age Poor job satisfaction Culture, remuneration & workloads Smaller DHBs may feel impact Sub-specialties may have critical shortages. Flexible working hours Ability to take leave Better remuneration and opportunities Improvement to DHB culture. We already have longterm entrenched shortages across the board We also have one of the lowest graduates per population rates in the OECD. We are continuing to depend very heavily on IMGs and the pressure on international shortages is likely to increase also. Frustrations with the culture and working conditions are an additional pressure on the public medical workforce. So all of this combined really points to the need for serious work on recruitment and retention of the existing medical workforce. We have to retain and support our older workers because they are crucial to the workforce.

Acknowledgements Participating members of the ASMS Professor Chris Frampton Lyndon Keene and Murray Barclay.

This graph shows the percentage of men and women in each age group who are intending to leave medicine entirely. So, all women in the 70+ age group who responded to the survey were intending to leave whereas only 1.7% of women in the 35-39 age group were intending to leave medicine entirely.

8.3% of all women were intending to not continue with some form of DHB-based employment in the next five years.

387

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