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Background to Succession Planning

Even in the best of times, the prospect of a GP leaving or reducing their workload is enough to concern a rural town. At best, there will be a worrisome time of finding a new doctor, of making sure that the intervening time does not mean that increased workloads of the remaining GPs will persuade some of them to also leave, and apprehension as to how a new doctor will settle. For the doctor leaving there has always been the guilt of leaving their community and the associated business handovers, as well as the excitement of retirement or a new position. At worst, the community has been left in crisis with no doctor, no access to medical records and little prospect of immediate relief.

The RDN Succession Planning service is another step in trying to avert such crises and ensure retention of medical services for rural communities. During 2003–04 the Australian Government Department of Health (formerly Australian Department of Health and Ageing) funded the NSW Rural Doctors Network (RDN) to conduct a Succession Planning Pilot Project among general practices in rural New South Wales (NSW). The objective of this project was to develop and pilot a model or models of succession planning in a rural general practice setting. The project included general practices in RRMA 3–7 areas of NSW and excluded corporate-for-profit practices.

A search of the scientific literature at the time indicated that there was no generally accepted succession planning model or models that rural general practice might adopt. The majority of succession planning research had focussed on large corporations and family businesses. Given that rural General Practitioner (GP) practices in NSW are generally neither large corporations nor family businesses that pass from one generation to the next, the findings were of unknown value to rural general practice.

However, key stakeholders in rural GP succession planning, who participated in two succession planning workshops that RDN held late in 2003, believed that the principles and steps of succession planning drawn from the literature could be modified to suit rural general practice, and that one model could be used to cover the wide range of rural GP practice settings.

These key stakeholders included rural GPs from a variety of practice settings, representatives of the then Rural Divisions of General Practice, community organisations, Area Health Services (now called Local Health Districts in NSW), Aboriginal health services and local government.

Participants at the succession planning workshops stated that this planning process should afford rural GPs options for a gracious exit when they decide it is time to move from their current practice, be it into retirement, to work in another town or in the city, or to take extended periods of leave.

As a result of the workshops, a single model of rural GP succession planning was developed. Selected rural GPs from a variety of practice settings piloted the succession planning model and, based on their evaluation, the model was refined. While it is called a model, the result is more an aide memoir that the GP can work through over time to achieve as good a result as possible for both the GP and the community. It has been tested by a number of rural GPs in differing locations and work environments. The single model will be different in practice for each doctor and each community.

There will never be a single or simple answer to the problems of retaining medical services in rural communities. The RDN Succession Planning service is one of a number of RDN contributions to make it easier for rural communities to retain those services.

Dr Ian Cameron
CEO – NSW Rural Doctors Network