Value of hospital-employed medical officers in rural Australia.
The author reports on a unique experience of the issues relating to recruitment and retention of specialist medical staff in a regional hospital in rural Tasmania, Australia. Based on a particular time of a high specialist medical staff resignation, the author identifies the importance to sustainability of rural medical specialists, of quality hospital-employed medical officer (HMO) support staff, a factor that has not been well recognized previously. It was found that HMOs, in particular senior or specialist-in-training HMOs, considerably reduced the workload of rural specialists, especially their after-hours workload. A rating scale to assess the acceptability of after-hours workload for rural specialists, taking into account the impact of HMO support, was developed and is presented in the article. The presence of quality supporting HMOs was a vital recruitment and retention issue for rural medical specialists at that time and can be generalised to other rural situations and should be officially recognised. The observations made support increasing the number of senior or specialist-in-training-HMO positions in rural hospitals in order to retain and recruit more rural specialists.