New Zealand Rural General Practitioners 1999 Survey--Part 3: rural general practitioners speak out

To describe themes about rural general practice from the written responses in the 'New Zealand Rural GPs 1999 Survey'.

A postal questionnaire surveyed all rural general practitioners (GPs) in New Zealand (NZ), who were asked for comments or suggestions about rural general practice. These responses were explored for themes about rural practice.

Of 338 completed questionnaires (response rate--75%), 138 contained written responses. The positive themes of rural general practice included: forming strong relationships with patients and the community, and practising the full spectrum of general practice, including emergency medicine. The negative themes included: heavy workloads, frequent on-call, inability to get time off, and feeling undervalued and underpaid by funders. Retention solutions included: better pay to adequately reflect the skills and workload, more salaried positions with guaranteed working conditions, and better rural continuing education. Recruitment solutions included: reducing barriers for foreign doctors to enter NZ, establishing a rural GP career pathway, and increasing the number of rural registrars.

This study highlights both the positive and negative features of NZ rural general practice, and makes it clear that further concerted and sustained action is required to improve retention and recruitment. The GPs' written comments provide detail on the challenges facing rural general practice, as well as informed comment about potential solutions.