When we talk about the healthcare distribution in the bush versus the cities, we rarely consider access to podiatry services. Now a national study of Australian podiatrists between 2017 and 2020 reveals almost a quarter of the podiatrists surveyed are likely to leave clinical practise or the entire field within five years. Equal access to podiatry services is essential as poorer foot health outcomes, such as higher amputation rates, have also been identified in people outside of cities.
This predicted loss of podiatrists nationally is alarming because demand for podiatry services is forecast to increase until the 2050s due to the increasing burden of chronic disease and an ageing population, particularly in regional, rural and remote locations where there is an increasingly higher prevalence of chronic illness.
In a study published in the Journal of Foot and Ankle Research, PhD student Anna Couch, Associate Professor Cylie Williams and Professor Terry Haines from the Monash University School of Primary and Allied Health Care, surveyed 1129 podiatrists nationally from 2017 to 2020. They found that podiatrists from a rural background (30%) were more likely to work rurally,– while podiatrists who undertook a regional/rural placement during their undergraduate education were more likely to work in a metropolitan location.
Importantly, the study found that 26% podiatrists indicated they were planning to leave direct patient care within 5 years because they were:
- unsatisfied with working conditions
- unsatisfied with opportunities to use their abilities
- perceived less personal accomplishment
- perceived less job satisfaction
Twenty-one percent of podiatrists indicated that they were planning to leave podiatry work entirely within 5 years because they were less satisfied with opportunities to use their abilities; had a poor support network from other podiatrists; had less job satisfaction and did not have access to paid annual leave.
Approximately 6% of the Australian podiatry workforce are located in outer regional or remote settings, with an estimated 16 podiatrists per 100,000 in major cities and 6 to 10 podiatrists per 100,000 in outer regional or remote settings.
According to Ms Couch, the findings suggest an emphasis on ensuring podiatry students from cities who undertake rural placements need further encouragement to stay once they graduate. “In Australia, people living in rural and remote areas experience higher rates of illness, hospitalisation and death when compared to other Australians, yet these are the areas where there are greater shortages of health workers, and this is true for podiatrists as well,” she said.
“To retain podiatrists, it is important to ensure access to leave, professional support, and appropriate physical working conditions.”
Associate Professor Williams added that podiatrists play a fundamental role in the provision of health care in different settings including acute hospitals, sub-acute rehabilitation services, community health services, aged care, private practice and with participants of the National Disability Insurance Scheme. “General practitioners increasingly rely on podiatrists for the management of people with foot problems. Chronic disease management plan funding through Medicare, in collaboration with general practitioners, has been effective in increasing access for people to podiatry services,” she said.
“Retaining podiatrists in the profession is critically important for optimising rural workforce supply, the development of strong relationships with people who have foot health needs, and enhancing health outcomes within all communities.”
