Home' News Bulletin : ADA News Bulletin July 2016 Contents OPINION
rural communities.8 This can result in workforce ‘churn’, by which
we mean the regular turnover of dental practitioners as they move
out of rural areas into more urban areas. This churn takes important
skills, knowledge, and expertise away from rural areas, and leaves
behind a scarcer, more dispersed, more unskilled workforce
servicing more disadvantaged populations for which there is greater
need for these skills.
There are several other issues with DRISS. Eligible applicants must
be registered with the Dental Board of Australia as a general dentist.
This does not allow for specialists to apply, all of whom provide
important dental services. Dentists wishing to apply have to be
intending to carry out private practice. Research has shown that
private dentists believe that some rural areas in Australia simply do
not have a population large enough to sustain their work.
also risks associated with using simplified measures of workforce
maldistribution in identifying areas of need.9
Australian rural areas differ greatly in their cultural, political, social
and economic makeup. There are complex and interrelated factors
that can affect the supply of and demand for dental treatment
in rural areas. Simply moving to a ‘more regional, rural or remote’
area than the location of the current practice, without identifying
the demand or patient base, is failing the purpose of the scheme.
The scheme aims to determine the needs and provide support
to rural and remote communities in the establishment and
expansion of dental practices3 but without actually doing this. Most
recruitment strategies are financial in nature,
10 and DRISS follows
this established pattern. The long-term effectiveness of many of the
strategies aimed at increasing the rural dental workforce is unable
to be measured.
DRISS seeks to improve access to dental treatment in previously
underserved rural areas. This would almost certainly require private
practitioners to treat a mixture of public and private patients. This
is allowed under the eligibility criteria, and should be encouraged
in disadvantaged rural areas. This could address the needs of rural
people who cannot afford to seek private dental treatment, but
who are unable to travel the long distances required to visit a
There are many complex reasons for workforce recruitment,
retention and turnover. Dental practitioners are often attracted
to rural practice by a combination of attractive and sustainable
financial returns, lifestyle factors, and the opportunity to establish
their own practice.
Incentives that could better address long-
term retention would be those focused on offering personal and
professional support, consultation and financial incentives for rural
retention. There are several approaches that could improve the
long-term retention outcomes of DRISS. These include increasing
the scope of eligibility for dental specialists and allowing already
established rural practitioners to expand their practices by taking on
another dentist, and/or more support staff.
There should be a more thorough analysis of the area identified
by the practitioner for their new practice. Currently, the only
requirement is to move to a more rural area than that of the original
practice. Under these guidelines, a practitioner could move only a
very short distance, or from a major city to an inner regional area,
where there is not a shortage. The scheme could better address the
rural/urban distribution issue by requiring moves to outer regional,
remote or very remote Australia, with higher financial rewards
accompanying those to the most remote locations, and providing
retention bonuses to those who remain in these areas for periods of
five or more years. Rural retention is also associated with integration
into the local community.
12 Consultation with the local community
and the new dental practitioner (and importantly their families) can
facilitate a sense of belonging and feelings of being valued that can
improve retention rates.
Any potential moves into a rural area that already has an existing
practice should be conducted in partnership or at least discussion
with the local established dentist. It is unfair for a competitor to
receive a financial incentive while an existing practitioner in the
ADA NEWS BULLETIN | JULY 2016 | 39
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