Background:Optometry is a regulated health profession in NZ, with limited student places. With 650 registered optometrists in 2005, the optometrist to population ratio was 1 : 6,291 with no apparent national shortage. If optometrists registered in NZ do not actually live there, a workforce shortage is possible. This paper presents findings from the New Zealand Association of Optometrists 2006 workforce survey of members, which aimed to profile the NZ optometric workforce and to explore factors relating to workforce capacity, job stress and future planning. Methods: A questionnaire was developed to collect information on employment status, hours worked and gender distribution of optometrists in New Zealand. It was circulated to 530 active members of the NZ Association of Optometrists representing 86 per cent of the available optometrists. Direct comparisons with the Australian optometric workforce numbers were also undertaken. Results: Of the 243 respondents, 129 (53 per cent) were male. The median age of all respondents was 39 years (46 for males and 34 for females) and 75 per cent of the respondents were aged younger than 50 years. Fifty per cent had practised 15 years or less. Ten per cent of respondents had 'time-out' during their career and this was significantly more likely for females. Nearly half the respondents were self-employed (46 per cent) and eight per cent worked as locums. Part-time employees were more likely to be female and males were more likely to be in full-time self-employment. Half the group was under 40 (51 per cent), which accounted for 86 per cent of the full-time salaried arrangements. Those aged 30 to 39 included 52 per cent of the total part-time salaried workers. The average working week was 34 hours for women and 39 hours for men; the median was 40 hours for both groups. In the typical working week, 80 per cent of an optometrist's time was spent consulting with patients and five per cent was patient-related paperwork. The distribution of work arrangements was remarkably similar among New Zealand optometrists, New Zealand GPs and Australian optometrists. In 2006, there were 619 optometrists assessed as working in New Zealand. This equated to 544 EFTOs and a ratio of EFTO to population of 1 : 7,517. Conclusions: The New Zealand optometric workforce in 2006 was sufficient to meet the overall population needs. One-third of optometrists chose to work part-time and the proportion of female optometrists has increased over the past 15 years. In the face of expected increasing demand for optometric services, a targeted expansion of the workforce appears desirable.
This study examined factors inhibiting and enhancing the development of primary medical care within community health centres. Nine centres with medical services, representing a range of financial administrative arrangements and a spread of locations, were selected for investigation. A modified version of the Community Health Accreditation and Standards Project (CHASP) review process was developed to look at areas of health service functioning. Effective internal management and a shared ethos were the strongest predictors of favourable outcomes overall. Salaried, as opposed to fee‐for‐service, financial arrangements led to better outcomes in most function areas, although salaried arrangements in themselves were not sufficient to produce good outcomes. All centres that performed well had community management structures, but the presence of such structures did not always guarantee good outcomes. The educational background and experience of the doctors had no effect. The study confirmed that primary medical care within community health centres represents a viable, alternative model of general practice in Australia and identified some factors that could strengthen it further.
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