What Makes for a Stable Senior Rural Hospital Medical Workforce? A Qualitative Case Study

Rural hospitals in Aotearoa New Zealand (NZ) struggle to recruit and retain their senior medical workforce. This study focuses on one rural hospital (Dunstan) with a stable senior medical workforce to explore factors influencing its success.

NZ Rural Hospital Medicine Fellows participated in virtual semi-structured interviews exploring their experiences and perceptions of why the hospital under study has a stable senior medical workforce. Thematic analysis using a positive deviance approach was undertaken.

Seventeen participants were recruited. Four themes were identified: (1) 'A great place to live' relates to Dunstan's rural hospital location and regional amenities; (2) 'A scope of clinical practice that Fellows enjoy' reflects on the model of care at Dunstan Hospital; (3) 'Strong collaborative relationships' describe successful internal (within the rural hospital) and external (professional and academic) relationships; (4) 'Purposeful investment' conveys the time and leadership required to build relationships, establish the professional environment, and continue to look forward.

Successfully building and maintaining a stable senior medical workforce in NZ rural hospitals requires investment. Findings show what can be achieved through sustained longstanding partnerships, both locally and nationally, and the critical role of supportive management. Building and maintaining a desirable professional environment for the senior medical workforce and other clinicians could enhance recruitment and retention, as does a robust connection with professional training and academia.