Dental practitioner rural work movements: a systematic review

Diana Godwin,Leonard Crocombe,Ha Hoang,Erica Bell

doi:10.22605/rrh2825

Abstract

There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Dental practitioners provide important primary healthcare services to rural populations. Workforce shortages and stability issues in underserved areas can have negative effects on rural communities. Strategies used to fix the dental practitioner workforce maldistribution need to be investigated. The study had primary focus on Australia and included relevant international literature. Databases used were PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Informit, Web of Science, Scopus and Summon. Search terms included dental practitioner, rural, remote, retention, recruitment and strategies. Sixteen articles met the inclusion criteria. The articles described a total of eight different positive factors and 12 negative factors towards rural practice. The positive factors related to the nature of the type of clinical work being a 'challenge', close social and professional support networks, enjoyment of rural lifestyle and successful integration into the rural community. The negative factors mentioned included social and professional isolation, workload and type of clinical work, access to further education opportunities, access to facilities, education for children and job opportunities for a partner, and inability to integrate into the rural community. The articles that analysed recruitment incentives described three strategies currently used to influence recruitment, all of which were financial or contractual in nature. Articles mentioning retention factors described seven long-term retention motivators; of these, six of them were personal reasons. The most commonly mentioned motivational factor for recruitment and retention of the rural dental practitioner workforce was the effect of prior rural exposure for dental practitioners. The results of this review indicate that the most important influences on rural dental practitioner workforce recruitment and retention were a combination of financial reimbursement and personal reasons. There was also a large influence of rural medical workforce research on untested assumptions and drivers of the rural dental practitioner workforce. The high recruitment rate compared with the low retention rate indicates that current strategies were not effective in addressing rural dental practitioner workforce shortages in the long term.

Highlights

There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in Organisation for Economic Cooperation and Development (OECD) countries
Successful recruitment initiatives and long-term retention schemes for rural dental practitioners are important to improve the oral health of people in underserved areas[5]
This review found many of the studies that fit the review criteria to be unable to comprehensively describe or investigate motivational factors beyond the boundaries of particular geographical areas or timeframes

Summary

Introduction

There is a globally observed unequal distribution of dental and other health practitioners between urban and rural areas in OECD countries. Conclusions: The results of this review indicate that the most important influences on rural dental practitioner workforce recruitment and retention were a combination of financial reimbursement and personal reasons. Recruitment and retention of health practitioners is a common problem faced by rural communities[4] Dental practitioners such as dentists, dental therapists, dental hygienists, oral health therapists and dental prosthetists/dental technicians provide important primary health care services to rural populations. Successful recruitment initiatives and long-term retention schemes for rural dental practitioners are important to improve the oral health of people in underserved areas[5]. A systematic review was needed to better understand and synthesise the available evidence of the factors that influence dental practitioners’ decisions to work and stay working in rural areas and the strategies engaged to facilitate recruitment and retention of the rural oral health workforce.

Objectives

Methods

Discussion

Conclusion