Dispelling the myths about rural consultant physician practice: the Victorian Physicians Survey

OBJECTIVE: To quantify the barriers to practising as a rural consultant physician. DESIGN: Cross-sectional postal survey. PARTICIPANTS: All 981 practising consultant physicians in Victoria, Australia, who were Fellows of the Royal Australasian College of Physicians in 1999; 52 (100%) of rural physicians and 634 (68.2%) of metropolitan physicians completed the survey. MAIN OUTCOME MEASURES: Demographic and practice characteristics; barriers to rural practice. RESULTS: There were no rural female consultant physicians, and 35 of the 52 rural consultant physicians (67.3%) were born in a rural area. The most important perceived barriers to rural practice identified by both metropolitan and rural physicians were children's schooling (72.2%), spouse's occupation (65.7%), other issues related to children (66.7%) and difficulties getting back into metropolitan practice (45.7%). Among metropolitan physicians, barriers to rural practice differed by age, sex, place of birth and nationality. Returning to metropolitan practice, children and concern over procedures were more likely to be reported as barriers to rural practice among those aged 40 years or under, 41-50 years and 51 years and over, respectively. CONCLUSION: The major barriers to rural practice identified by physicians lie outside the health sector, and particularly concern a perceived need for wider opportunities in children's education and spouse employment.