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Table 6 Major theme and subthemes: Impact of management

From: Retention of allied health professionals in rural New South Wales: a thematic analysis of focus group discussions

Subthemes

Examples

Management skills

One thing I've probably learned over the last couple of years that makes people leave is bad management… like there's not flexibility… A bit more transparency about access to PD for managers would be good, but often it's the tiny things that just eventually add up, someone snaps and says, “That's it, I'm out of here. (G2-SP-Female-age 32)

Clinical support for new graduates

As a relatively new graduate I was really well-supported… until I got here and then I realized that there was nobody here anymore. There was no support – the structure just really wasn’t there to encourage you to stay. (G4-PT-Male-age 57)

Support for isolated practitioners

And I know I’ve got friends who are doing that sort of outreach stuff to smaller towns that have those experiences of being working there for a year, and they’re at the point where they’re like, “I’ve almost had enough of this,” because they just haven’t had that support. (G4-SW-Female-age 24)

Recruitment

R1: Health service must support reasonable application for recruitment. What we've had here is a situation where they have illogically said no. Not given any reason, not given a time frame…You're not sure why they're saying no, and if they ever will say yes. That's terrible. That affects morale. That’s the death toll. (G5-MGR-Female-age 45)

R2: Well the ones that are left here say, “What's the point?” If that’s the way they value the professionals, why bother staying around? Why would I even bother? (G5-OT-Female-age 45)

Ethical dilemmas

That’s why I left health services, because operating in the health services was professionally compromising me because you had to be responsible to the system, rather than directly responsible to your client, and quite often the demands of the system are disparate to what the needs of the client are. (G4-PT-Male-age 57)

Work sector

What prompted me to move from clinical into academia was the frustration with [our service] going from being managed by [a private company] to being managed by [a public health service]… and I went through 3 directors and I couldn’t do it anymore. And it’s only that I’m still rural and still at [this regional university]. Otherwise I would have left this place altogether. (G4-RAD-Female-age44)

  1. Clinical managers often took on an advocacy role particularly in relation to CPD access, annual leave, flexible hours, and autonomy.