Why doctors leave rural practice.

Retention of rural doctors remains difficult because of complex factors that influence decisions of medical families. This study explores the reasons why Queensland rural doctors left their communities during 1995. Semi-structured interviews were conducted with contactable former rural doctors who claimed that they had entered rural practice with the intention to stay for a substantial period of time. The interviews were audiotaped, transcribed and analysed using NUD.IST software. Participants appeared to be subject to a dynamic balance between opposing pressures to stay and pressures to leave. In time, they became susceptible to 'triggers' to leave. These triggers were sometimes locality-specific and could be difficult to address, particularly without early intervention. We believe that it should be possible to develop strategies that address specific concerns of rural doctors, particularly if they are identified early. The optimum period of stay in rural practice should be reconsidered, such that moderate stays should be rewarded in a way that retains the doctors in some form of rural, or near-rural practice.