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Melbourne Institute Monash University Medicine in Australia: Balancing Employment and Life (MABEL) Understanding the Dynamics of the Medical Workforce: The MABEL longitudinal survey of doctors Authors: Professor Anthony Scott, 1 Dr Catherine Joyce, 2 Professor John Humphreys, 3 Associate Professor Guyonne Kalb, 1 Dr Julia Witt, 1 Dr Sung-Hee Jeon 1 1. Melbourne Institute of Applied Economic and Social Research, The University of Melbourne 2. Department of Epidemiology & Preventive Medicine, Monash University 3. School of Rural Health, Monash University Abstract ➤ The MABEL survey aims to investigate the dynamics of the medical workforce in Australia. ➤ All Australian doctors were invited to participate in the first wave of the study in May 2008. ➤ Information is being collected about job satisfaction, job characteristics, family circumstances, income, and workforce participation. ➤ MABEL provides a new evidence base about Australian doctors’ decision- making about work. Methods ➤ MABEL is a cohort study with annual waves of data collection. It has been funded for five years by a Health Services Research Grant from the National Health and Medical Research Council. ➤ The sampling frame includes all Australian doctors working in clinical roles, defined using the Australasian Medical Publishing Company’s Medical Directory. ➤ Data are collected on training, registration status, workplace and job characteristics, job satisfaction, family circumstances, and individual and household earnings. A discrete choice experiment examines doctors’ preferences and trade-offs for different types of jobs. Figure 1: Example of DCE for GP questionnaire ➤ Different versions of the survey questionnaire were created to tailor the content to four groups of doctors: general practitioners; specialists; specialists in training; and non-specialist hospital doctors. ➤ For the first wave of the survey, all doctors in the sampling frame were mailed a personal invitation letter, a copy of the survey questionnaire and reply paid envelope, with an option of completing an online version. Figure 2: Workforce participation outcomes and key determinants Please use the following table to answer questions 5 and 6: B b o J A b o J Change in earnings 15% increase No change Change in total hours worked e s a e r c n i % 0 1 e g n a h c o N On-call arrangements 1 in 4, frequently called out 1 in 2, frequently called out Location Coastal town, population < 5,000 City or large regional centre, population > 20,000 Social interactions d o o g y r e V d e t i m i l y r e V Arranging a locum on short notice is Rather difficult Moderately easy The practice team includes GPs, receptionist and nurse GPs, receptionist, nurse and practice manager Average consultation length s e t u n i m 0 2 > s e t u n i m 5 1 5. Which job do you think is better? B b o J A b o J 6. Which job would you choose? b o j t n e r r u c y m t a y a t S B b o J A b o J Working in collaboration ➤ The MABEL Policy Reference Group is comprised of key stakeholder representatives, to ensure that the questions investigated are relevant to current policy issues and decisions, and that the findings generated by the study are translated into the policy context. ➤ MABEL is endorsed by major medical professional organisations such as royal colleges, rural medical groups and medical educational agencies. The baseline cohort ➤ Preliminary response data for Wave 1 (prior to distribution of reminder letters) shows a 13.7% response rate to date (Table 1). ➤ Preliminary data indicates that the Wave 1 sample is similar to the total national medical workforce with respect to age and gender; with some over- representation of doctors in remote and very remote regions (as anticipated) and of specialists, with under-representation of non-specialist hospital doctors (Figure 3). ➤ Around 20% of returns were completed online. Table 1: Wave 1 response rate—Preliminary Doctor type All doctors General Specialists Non-specialist Specialists practitioners hospital in training doctors Invitations mailed out 54,168 21,930 19,344 8,730 4,165 Ineligible 1 1,305 295 447 394 156 Useable returns 2 7,242 2,834 3,058 820 530 Response rate 3 13.70% 13.10% 16.18% 9.58% 13.23% 1. Ineligible: return to sender, retired, not in clinical practice, other. 2. Useable returns: Excluding questionnaires returned blank. 3. Response rate: Useable returns / Total eligible. Figure 3: Representativeness of Wave 1 sample—Preliminary Conclusion ➤ MABEL is unique in medical workforce studies in Australia, and provides a new evidence base about Australian doctors’ work-related decision making. ➤ This will assist in providing policy makers with important evidence to underpin future workforce planning, identifying effective policy levers for the medical workforce, and ultimately assisting to improve support for doctors. Contact E: [email protected] W: www.mabel.org.au 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% GPs Specialists Specialists in training Non-specialist hospital doctors National Wave1 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% National Wave1 Male Female 0% 5% 10% 15% 20% 25% 30% <=30 31-40 41-50 51-60 61-70 >70 National Wave 1 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Very remote Remote Outer regional Major city Inner regional National Wave1 Remoteness category Age group Gender Doctor type
