AbstractBackgroundBurnout is highly prevalent among health practitioners. It negatively impacts job performance, patient care, career retention and psychological well‐being. This study aimed to identify factors associated with burnout among Australian podiatrists.MethodsData were collected from registered podiatrists via four online surveys administered annually from 2017 to 2020 as part of the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) study. Information was collected about work history, job preferences, personal characteristics, health, personality, life experiences and risk‐taking behaviours. Multiple logistic regression analyses were used to determine if (i) individual characteristics, (ii) workplace factors and (iii) job satisfaction measures were associated with burnout (based on the abbreviated Maslach Burnout Inventory).ResultsA total of 848 responses were included, with 268 podiatrists (31.6%) experiencing burnout. Participants experiencing burnout were slightly younger, more recent to practice, had poorer health, greater mental distress, lower scores for resilience, extraversion, agreeableness, conscientiousness, emotional stability and openness to experiences. They were less likely to have financial and clinical risk‐taking behaviour and more likely to have career risk‐taking behaviour. Prediction accuracy of these individual characteristic variables for burnout was 72.4%. Participants experiencing burnout were also more likely to work in private practice, have more work locations, work more hours, more direct patient hours, see more patients, have shorter consultation times, more likely to bulk bill chronic disease management plans, have less access to sick leave and professional development and be more likely to intend to leave patient care and the profession within 5 years than participants not experiencing burnout. Prediction accuracy of these workplace‐related variables for burnout was 67.1%. Participants experiencing burnout were less satisfied with their job. Prediction accuracy of these variables for burnout was 78.8%.ConclusionsMany of the factors associated with burnout in Australian podiatrists are modifiable, providing opportunities to implement targeted prevention strategies. The strength of association of these factors indicates high potential for strategies to be successful.

Understanding the dynamics of the podiatry workforce is essential for the sustainability of the profession. This study aimed to describe the podiatry workforce characteristics and identify factors associated with rural practice location. We used an exploratory descriptive design from data obtained during cross sectional study: Podiatrists in Australia: Investigating Graduate Employment through four online surveys (2017–2020). Demographic and workplace characteristics including career development were described. Univariate logistic regressions were used to determine associations with rural or metropolitan practice location. Data were included from 1, 135 podiatrists (21

Podiatrists’ earnings have an important influence on workforce dynamics. This includes the profession’s ability to attract and retain workers so the population’s healthcare needs can be met. This study aimed to describe financial characteristics of podiatry work and factors relating to a sense of financial security. This was a cross sectional study using data from Victorian podiatrists who participated in Wave 1 of the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) survey. Demographic and financial characteristics were described. The outcome measure, financial security, was collected through a self-reported belief based on current financial situation and prospects, respondents’ perception of having enough income to live on when they retire. Univariate logistic regression was used to determine associations with rural or metropolitan practice locations. Multiple ordered logistic regression was performed to explore associations between factors relating to financial security and retirement prospects. There were 286 Victorian podiatrist (18

Background Maldistribution of podiatrists limits capacity to address the footcare needs of the population. Understanding factors that impact recruitment and retention of Australian podiatrists is a key solution. The primary aim of this study was to describe factors related to rural podiatry work, and overall professional retention amongst Australian podiatrists. Methods We used data collected from the most recent relevant response of a cohort of Australian podiatrists between 2017 and 2020 of four online surveys. Person and job role variables known to impact current work and retention were collected. Logistic regression models were used to determine factors associated with rural work and intent to leave direct patient care or the profession entirely. Results There were 1129 podiatrists (21% of 5429) who participated in at least one of the survey waves. Podiatrists who had a rural background (30%) were less likely to work in a metropolitan location (OR = 0.20, 95%CI = 0.11,0.37). Podiatrists who undertook a regional/rural placement during their undergraduate education (43%) were more likely to work in a metropolitan location (OR = 1.86, 95%CI = 1.38,2.51). Podiatrists who indicated they were planning to leave direct patient care within 5 years ( n = 282, 26%), were less satisfied with working conditions (OR = 0.77, 95% CI = 0.66, 0.92), less satisfied with opportunities to use their abilities (OR = 0.83, 95% CI = 0.69, 0.99), perceived less personal accomplishment (OR = 0.94, 95% CI 0.86, 0.94) and less job satisfaction (OR = 0.92, 95% CI = 0.91, 0.98). Podiatrists who indicated that they were planning to leave podiatry work entirely within 5 years ( n = 223, 21%), were less satisfied with opportunities to use their abilities (OR = 0.74, 95% CI = 0.62, 0.88), agreed they had a poor support network from other podiatrists (OR = 1.35, 95% CI = 1.13, 1.61), had less job satisfaction (OR = 0.89, 95% CI = 0.86, 0.94), and did not have access to paid annual leave (OR = 0.62, 95% CI = 0.38, 0.99). Conclusion Findings suggest ways to promote rural work, including selecting university students with rural backgrounds, and optimising the experience of rural placements which currently predict metropolitan practice. To retain podiatrists, it is important to ensure access to leave, professional support, and appropriate physical working conditions. Further research is required to understand why intention to leave is so high.

INTRODUCTION:Access to healthcare services should be equitable no matter where you live. However, the podiatry needs of rural populations are poorly addressed, partly because of workforce maldistribution. Encouraging emerging podiatrists to work in rural areas is a key solution. The aims were to explore (1) recently graduated podiatrists' perceptions regarding working rurally and (2) broader industry views of the factors likely to be successful for rural recruitment and retention.METHODS:Recruitment for interviews pertaining to podiatrist recruitment and retention was conducted during 2017. Recruitment was through social media, podiatry professional association newsletters, public health podiatry emails. Graduate perceptions were explored via two focus groups of Australian podiatrists enrolled in the Podiatrists in Australia: Investigating Graduate Employment longitudinal survey. Industry views were explored through semistructured interviews with podiatry profession stakeholders. Inductive thematic analysis was used to analyse data about the perceptions of recently graduated podiatrists and stakeholders and the themes were triangulated between the two groups.RESULTS:Overall, 11 recent graduate podiatrists and 15 stakeholders participated. The overarching themes among the two groups were the importance of 'growing me' and 'growing the profession'. Three superordinate themes were generated through analysis of both datasets, including (i) building a career, (ii) why I stay, and (iii) it cannot be done alone.CONCLUSION:This study identified that recently graduated podiatrists are likely to be attracted to rural work and retained in rural areas if they foresee opportunities for career progression in stable jobs, have a background of training and living in rural areas, like the lifestyle, and are able to access appropriate professional and personal supports. Building employment that spans public and private sector opportunities might be attractive to new graduate podiatrists seeking a breadth of career options. It is also important to recognise rural generalist podiatrists for any extended scope of services they provide along with raising public awareness of the role of rural podiatrist as a core part of multidisciplinary rural healthcare teams. Future training and workforce planning in podiatry must promote podiatrists taking up rural training and work so that maldistribution is reduced.

The Podiatrists in Australia: Investigating Graduate Employment (PAIGE) study provides a systematic and rigorous evidence-base for rural podiatric workforce policy development, by developing a database modelled on the highly successful Medicine in Australia, Balancing Employment and Life (MABEL) longitudinal panel survey of Australian doctors. Analysis of data from waves 1 and 2 of this database, and concurrently collected qualitative data, address two key research questions about work location choice decisions and retention of podiatrists in location and the profession.

INTRODUCTION The maldistribution of health care workers between metropolitan, rural or remote areas is globally recognised. Allied health professional's workplace location choice is a complex interplay between professional and non-professional elements. Policy-makers should understand factors that influence workplace location choices when designing structures to attract allied health professionals to rural practice. OBJECTIVE To determine factors influencing recruitment and retention of allied health professionals in metropolitan, rural and remote locations. DESIGN Systematic review. FINDINGS Twenty-two studies met inclusion criteria. Extracted data were synthesised into subthemes: (a) opportunities for career development, (b) clinical load, (c) organisational and workplace structure, (d) previous location exposure and (e) personal factors. Of these 22 studies, 12 reported organisational/workplace structure and personal factors positively impacting recruitment and 11 studies discussed organisational and workplace structure also negatively impacting on retention. Career opportunities positively impacted on recruitment, while lack of opportunity negatively affected retention. Previous location exposure positively impacted recruitment however had limited impact on retention. Similarly, a diverse clinical load was reported as being attractive during recruitment, but unmanageable caseloads affected retention. DISCUSSION This review identifies the need for effective and sustainable solutions for the issues with recruitment and retention of allied health professionals. While the different allied health professions share similar recruitment and retention challenges, further research is needed to isolate factors impacting each discipline. CONCLUSIONS Retention and recruitment of different allied health professions is multifactorial. Organisational and workplace structure and opportunities for career development emerged as having impact on the recruitment of allied health professionals.

BACKGROUND:In the management of diabetes and high-risk patients, timely treatment with scheduled medicines is critical to prevent severe infections and reduce the risk of lower extremity amputation. However, in Australia, few podiatrists have attained endorsement to prescribe. The aims of this study were to identify the costs associated with developing and implementing a podiatry prescribing mentoring program; and to compare the cost of this program against potential healthcare savings produced.METHODS:This was a cost-description analysis, involving the calculation of costs associated with the development and implementation of a mentoring program to train podiatrists to become endorsed prescribers. Costs were calculated using the Ingredients Method and examined from the perspective of a public health service provider, and the individual learner podiatrist. Breakeven analysis compared the cost of training a podiatry prescriber for endorsement against the potential benefit (savings) made by averting complications of an infected foot ulcer. A sensitivity analysis was conducted to allow for uncertainty in the results of an economic evaluation.RESULTS:Total start-up cost for the podiatry prescriber mentoring program was $13, 251. The total cost to train one learner podiatrist was $30, 087, distributed between the hospital $17, 046 and the individual learner $13, 041. In the setting studied, a podiatry prescriber must avert 0.40 major amputations arising from an infected foot ulcer through prescribing to recover the cost of training. If in-kind training costs are included, total cost increases to $50, 654, and the breakeven point shifts to 0.68 major amputations averted.CONCLUSION:The economic benefits (savings) created by an endorsed prescribing podiatrist over their career in a public health service are likely to outweigh the costs to train a podiatrist to attain endorsement. Further research is required to help understand the effectiveness of podiatry prescribing in reducing diabetic foot related complications and the potential economic impact of podiatry prescribers on this health condition.