An anonymous survey of provincial, rural and remote obstetricians' long-term practice intentions; implications for the provision of specialist obstetric services outside metropolitan areas in Australia

Background: Objective data and anecdotal reports suggest that non-metropolitan Australia may face a severe shortage of specialist obstetricians in the near future. Aims: To assess the workload and practice intentions of specialist obstetricians working in provincial, rural and remote areas of Australia. Methods: 1. A structured questionnaire posted to Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) who undertake part or all of their work in provincial, rural or remote areas of Australia. 2. A telephone survey of all non-metropolitan hospitals in Australia. Main outcome measures: Demographic data (e.g. age, sex); length of time working in the area; practice characteristics; professional supports; workload; intentions for future practice; factors that might improve practice satisfaction. Results: Approximately 30% of Australia's births occur in non-metropolitan hospitals, of which 57% do not currently have specialist obstetric cover. Survey response rate of 73%. The rural workforce is older than the metropolitan demographic, and almost half of respondents intended to cease obstetric practice within 5 years. Conclusions: These data may presage a major public health crisis for rural Australia.