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Despite an increasing demand for therapy services, there is a shortage of therapists in rural areas. We describe the existing private therapy workforce in rural western New South Wales (NSW), Australia. A cross-sectional design study, using an online survey, was conducted with occupational and physiotherapists, speech pathologists, and psychologists working in private practice in western NSW. Forty-one private therapists completed the survey. The average years of qualification was 19; 51% worked part-time. Two-thirds (68%) indicated they had adequate access to professional development opportunities. Sixty-four percent reported intending to stay in their job for 12 months. Most (95%) reported high levels of job satisfaction. Respondents had worked in western NSW for a median of 17 yrs. Sixty-eight percent described opportunities for social interaction as very good. Sixty-six percent grew up in rural areas. All respondents agreed that they loved the rural lifestyle. The results portray an experienced, stable, flexible, and highly satisfied professional group. With the current changes in policies within the disability sector, it is important to maximise these features of private therapy in order to contribute to the rural workforce and increase access to the range of supports available for people with disability.

Background: Research on the international recruitment of health professionals to the U.S. has focused almost exclusively on physicians and nurses; we are aware of no research on the migration of allied health professionals., Objective: We examined the strengths and weaknesses of various public and private data sources on foreign-educated allied health professions in the U.S. and patched together a picture of these migrants. We focus on pharmacists, physical therapists (PTs), occupational therapists (OTs), speech language pathologists (SLPs), and medical and clinical laboratory technicians (lab techs)., Findings: Based on the American Community Survey, we found that 12% of PTs, 12% of lab techs, 8% of pharmacists, 4% of OTs, and 3% of SLPs are foreign-born and entered the U.S. at age 21 or older. Among foreign-born PTs, about half remain as non-citizens, suggesting the highest proportion of recent arrivals among the five professions., Conclusions: As Congress debates comprehensive immigration reform, one of the much need changes to the system is better immigration data, disaggregated by occupation.

The purpose of our study was to investigate the importance of different items as reasons for leaving the Emergency Medical Service (EMS) profession. An exit survey was returned by three distinct EMS samples: 127 full compensated, 45 partially compensated and 72 non-compensated/volunteer respondents, who rated the importance of 17 different items for affecting their decision to leave EMS. Unfortunately, there were a high percentage of "not applicable" responses for 10 items. We focused on those seven items that had a majority of useable responses across the three samples. Results showed that the desire for better pay and benefits was a more important reason for leaving EMS for the partially compensated versus fully compensated respondents. Perceived lack of advancement opportunity was a more important reason for leaving for the partially compensated and volunteer groups versus the fully compensated group. Study limitations are discussed and suggestions for future research offered.

Unlabelled: The purpose of this study was to identify factors related to a student's decision to enroll in college/university allied health education programs. The secondary purpose was to create a scale that can be used by colleges and universities to assess decision-making among prospective and current allied health education students., Methods: We identified factors and developed the scale in 4 stages: 1) review of the literature, 2) focus group studies, 3) pilot testing, and 4) administration of the scale and testing of measurement properties. Research participants (n = 1,123) were students enrolled in allied and non-allied health education programs in Tennessee., Results: In exploratory and confirmatory factor analyses, this study identified six factors linked to the decision to enroll in allied health education programs: personal influence, social influence, academic preparation, career opportunity, individual aspiration, and self-efficacy. Discriminant function analyses further revealed that these factors predicted program enrollment status., Conclusion: Although this scale may not be generalizable to all allied health education fields, it may assist universities and colleges in targeting and recruiting students into their allied health education programs.

Health care and higher education intersect in important fundamental ways. This essay focuses on the crossroad where the two entities meet, which may be envisioned as constituting two intersecting multilane highways complete with on ramps, off ramps, passing lanes, and breakdown lanes. Some lanes also may be characterized by the movement of vehicles that only can be sighted periodically. For example, federal budgets and decisions on appropriations usually are seen at specific intervals during the year.

An exit survey was returned by a sample of 127 respondents in fully compensated positions who left the EMS profession, most within 12 months prior to filling out the exit survey. A very high percentage continued to work after leaving EMS. Respondents were asked to rate the importance of each of 17 items in affecting their decision to leave EMS. A higher than anticipated response to a "not applicable" response choice affected the usability of 8 of these items. Nine of the 17 items had at least 65 useable responses and were used for further analysis. Within these 9, stress/burnout and lack of job challenges had the highest importance in affecting the decision to leave EMS, while desire for better pay and benefits had the lowest importance. Desire for career change was positively related to life satisfaction after leaving EMS and negatively related to likelihood of returning to EMS. Stress/burnout was positively related to life satisfaction after leaving EMS. Study limitations and future research issues are briefly discussed.

The recruitment and retention of allied health workers present challenges for organizations in Australia and internationally. Australia, in common with other developed countries, faces the prospect of a rapidly aging population and the high turnover of younger allied health workers (the majority of whom are female) from employing organizations. Emphases on the individual characteristics of Boomer, Generation X, and Generation Y workers may provide a useful starting base for recruitment and retention strategies, but our study shows that these need to be contextualized within broader political, social, and structural factors that take account of gender and the changing needs of workers over their life span.

Recruitment of academically gifted students for Communication Sciences and Disorders, (Speech Language Pathology) Occupational Therapy and Physical Therapy programs has been a challenge for the past few years. A student survey was created to provide insight as to when in their academic development and what methods are used by students to make program selections. Outcomes from this study include: (1) when students made career choices; (2) what influenced them in their career choice, (3) how and why they selected their future profession, (4) the number of programs applied to, and (5) the reasons they selected our university. As a result of this survey, recruitment methods have been enhanced to more actively recruit students during high school and to ensure that personal, volunteer or work-experience is included in the recruitment process.

This article examines the growth and geographic distribution of selected health professions in a 26-year period. The health professionals investigated were physicians, dentists, pharmacists, registered nurses, other health practitioners, dieticians and therapists, medical technologists and technicians, and health service workers. Allied health professions are represented by the last three of these groups. Samples of health professionals were extracted from the Current Population Survey from 1971 to 1996. The ratio technique and GIN1 index are used to describe the growth trend and geographic distribution of each health professional group over time. This historical overview reveals the following general trends in the 1990s: 1) growth of every selected health professional group has slowed down; 2) workforce disparities between the most and least abundantly supplied geographic areas have decreased; 3) selected health professions have become less evenly distributed among the population; and 4) the trends in pharmacy and dentistry call for immediate attention in workforce planning. The findings suggest that with the exception of dentistry, health personnel shortages are no longer an issue in such planning. Future health workforce policies should continue focusing on improving the distribution of workers among the general population.

In summary, it is evident that there is a great need for the collection of much more definitive data. I believe these data are essential to those in decision making positions and ASAHP would be an appropriate organization to collect and disseminate these data. I would urge you all, when you receive a survey from ASAHP asking for manpower related data, to be certain that the survey is completed, is accurate, and is returned. We will try to insure that the instructions are clear and precise. Perhaps we need to make our data collections state specific. We certainly need to include information regarding the level of managed care in each institution's area so that we can begin to examine the effects of managed care on the placement of our graduates. I also believe it is important to identify trends in employment because this makes possible rational decisions about program size and discontinuation and also insure the provision of programs that will benefit our graduates and the communities we serve. Although data from this survey were not presented in this article, the author would like to express her profound gratitude to Ms. Soon Merz, Director of Institutional Research and Planning and Ms. Amy Rhoads, Associate Director of Institutional Research and Planning at Kansas University Medical Center for their considerable work in analyzing and summarizing the data.

Over the last decade, the increasingly severe workforce shortages developing in some allied health professions have drawn the attention of university, government, and institutional researchers and policymakers. A 1991 American Hospital Association survey shows allied health professions dominating the "vacancy rate" list, with physical therapy (PT) and occupational therapy (OT) at the top. Separate surveys have documented growing shortages in the OT and Certified Registered Nurse Anesthetist (CRNA) areas. According to a recent survey by the South Carolina Hospital Association, hospital vacancy rates in OT and PT are particularly severe, but there are also significant shortages in the CRNA and Medical Technologist (ASCP) subfields. The imperatives of cost containment are increasing the demand in South Carolina and elsewhere for rehabilitative and outpatient care provided by many allied health professionals, but there is growing concern that the educational system will not be able to respond adequately to these growing workforce needs. These predictions of growing shortages are further confirmed by recent occupational forecasts issued by the US Bureau of Labor Statistics. Allied health researchers do not completely agree on the reasons for the development of subfield shortages, or on how severe they really are. Improving alternative career prospects for females low public and professional images, and employee burnout, among other factors, have been suggested. A survey of the allied health literature shows four additional broad areas of investigation.

The aim of this paper is to discuss labor force planning issues for allied health professionals in Australia. Health system reform and changes in the demand for health labor, combined with key characteristics of the professions, will have a profound influence on future needs for career development of allied health professionals. Key issues include the increasing need for allied health professionals to undertake business management and public health training, the growing trend of multiskilling versus specialization, and the need for the professions to diversify their skill base to ensure a range of career options in a changing health care system. The challenge for allied health professions is to improve tools of analysis in relation to labor force planning and to systematically investigate various factors influencing labor force supply and demand, on both a short-term and long-term basis.

ASAHP recommends that the federal government should, as the largest consumer of health care, play a central role in partnership with state governments and private institutions in reducing shortages of allied health personnel. Furthermore, ASAHP believes that this role should encompass attracting students (particularly from minority and underserved portions of the population) both to academic allied health programs through the provision of entry-level traineeships and advanced programs which prepare allied health professionals for careers as educators and researchers. No federal programs were authorized specifically to support allied health education during the period from 1981 to 1989. PL 100-607, the Health Professions Reauthorization Act of 1988, authorized $6 million ($2 million in each of three categories), but only $737,000 was appropriated in FY 1990 for Allied Health Grants and Contracts. The Bureau of Health Professions subsequently received 122 proposals in February 1990, representing more than $10,000,000 in requests for this limited amount. Since then, the Bureau has received an average of 100 proposals for each annual funding cycle. In addition to providing continuation grants for existing projects, the Bureau is currently able to award an average of 10 new grants each year. The $3,935,000 appropriated for FY 1995 will be used to fund perhaps another 12 to 15 initiatives. ASAHP believes that substantially more financial assistance is required than what is currently being appropriated. Furthermore, the most suitable venue for the federal government to affect reductions in the shortage of allied health professionals is through the advanced training portion of the Section 766 Program, which remains unfunded.(ABSTRACT TRUNCATED AT 250 WORDS)

Few studies examine rural and urban differences in supply and demand for allied health professionals. This research examined ten allied health professions for rural and urban differences in employment and vacancies across four types of hospital settings. Based on data from a Georgia workforce study, significant differences in employment rates were noted for medical technologists, medical laboratory technicians, licensed practical nurses, registered nurses, and social workers. Significant size x location differences in vacancy rates were found for registered nurses and respiratory therapists. This study suggests that rurality and hospital size may impact levels of employment and vacancies in selected professions, and that a detailed workforce analysis is needed by profession, employment sector, and geographical area to establish a clear picture of health care services needed by the population.

Upon learning that 95% of all fatal traffic accidents occur within three miles of one's home, an acquaintance moved to another residence four miles away and is still alive today. The world might be a much better place if most obstacles could be overcome this handily. Unfortunately, the problem of allied health personnel shortages appears to be more intractable. Because the situation is complicated in nature, it is most unlikely that any single remedy will suffice. Public and private interests have joined forces in many states, but it is abundantly clear that conventional market forces are unlikely to prevail. These forces usually focus on supply and demand. While shortages may cause entry-level salaries to rise, they do not stimulate academic institutions to increase their output nor will they affect the availability of research funding and/or doctoral training programs. Current market forces compel health facilities to engage in bidding wars for scarce manpower. Although individual job seekers may benefit, this practice does not increase the number of training program graduates. The federal government has a decisive role to play in assuring an adequate number of personnel to meet this nation's health care needs. Assistance is necessary in the form of providing entry- and advanced-level traineeships to accelerate the flow of part-time students pursuing doctorates, and to fund model student recruitment/retention projects. This role should encompass attracting students (particularly from minority and underserved portions of the population) to academic programs. The Disadvantaged Minority Health Improvement Act, PL 101-527 that was enacted in November 1990, contains only minimal provisions for allied health. Eligibility for student scholarship assistance is restricted to a small handful of allied health professions. Moreover, allied health is not eligible for the loan repayment program aimed at individuals who agree to serve on the faculty of health professions schools that historically train individuals from disadvantaged backgrounds. It is difficult to envision how serious underrepresentation of minorities in allied health will be affected by this legislation. Clearly, special consideration by the federal government is required to produce a cadre of allied health caregivers drawn from the ranks of those whom they serve. Allied health research is needed to expand the basis for practice, increase knowledge, and generate studies pertaining to the efficacy of practice. Funding is required to support the development of scholars and scholarship in allied health institutions to ensure a pool of qualified faculty members. Finally, many difficulties result from a lack of governmental visibility.(ABSTRACT TRUNCATED AT 400 WORDS)

Recent attention has focused on integration of Multicompetent Allied Health Practitioners (MCAHPs) into the health care labor force to offset future imbalances in supply and demand for allied health practitioners, and to maximize use of existing allied health practitioners. Several recent studies have focused on multicompetency issues. However, there is little that shows the impact of MCAHPs on health care costs. This study was conducted to determine the current usage of MCAHPs, projected future need for them, needs-skill combinations, entry-level salary comparison between MCAHPs and single-skilled practitioners, projected yearly savings in personnel costs to health care organizations employing MCAHPs, and community support for a college-based MCAHP program. Results indicated a large market for MCAHPs, increased entry-level salaries for MCAHPs compared to single-skilled practitioners, and projected savings to health care institutions due to decreased personnel costs.

This article focuses on the salient issues and problems regarding allied health manpower in Kuwait, an oil-rich Gulf country. The health system in Kuwait has expanded very rapidly since the country's independence 29 years ago. A major feature of the health system is its heavy reliance on expatriate workers, constituting 80% of all doctors and over 90% of all nurses. Local training facilities have started producing some of the required allied health professionals. Continued shortages of indigenous allied health professionals are, however, inevitable in most areas. The presence of a highly diverse expatriate workforce raises serious problems, concerning worker conflict, differential skills and competencies, and adjustment to the Kuwaiti culture. Standardizing local training facilities, curricular expansion to accommodate emerging health concepts, and improving the system of hiring expatriates are needed.

The distribution of health personnel and the resulting shortages of health care to economically depressed, ethnic, rural and inner city areas is a serious problem. Recruiting students from and training them in underserved areas has been suggested as one way to improve retention rates among graduates of allied health programs. A one-year follow-up survey of 1974 graduates of allied health programs sponsored by an Area Health Education Center located in an underserved, one ethnic group predominant rural area was done to test this approach. Results show that of the 122 graduates surveyed in this study, one year after graduation 85% had returned to work in the area of their previous residence. Among professional groups, licensed vocational nurses experienced the least migration. Generally, professions requiring higher levels of education showed higher relocation rates. Sex and ethnicity were related to these findings. The appeal of higher salaries or material benefits alone did not appear to attract graduates to migrate. It appears that communities with shortages of health manpower due to maldistribution may be successful in correcting this problem by recruiting students from their own area. Possible explanations and recommendations related to these findings are discussed.

This study sought information relative to student capacity and enrollment, quality of applicants, numbers in the applicant pool, and program directors' estimates of the job market and salaries, as well as overall impressions of their respective professions in six allied health disciplines: medical technology, physical therapy, radiologic technology, occupational therapy, dietetics/nutrition, and medical record administration. Of 105 four-year colleges and universities surveyed, 252 programmatic responses were received from 83 institutions (79% response rate). Generally, the status of these six allied health professions appeared very good, with a 2 to 1 overall ratio of applicants to graduates, and an almost 6 to 1 ratio in physical therapy. The average GPA for incoming allied health students was 3.01. Job opportunities were considered plentiful, and 93% of program directors rated the overall outlook for their respective professions as good to excellent. However, there were four areas that program officials may wish to examine more closely: excessive length of some professional programs, numbers of minorities in the institutions surveyed, entry-level salaries for several professions, and a somewhat less positive atmosphere in medical technology as compared to the other five disciplines.

The growth and geographical distribution of selected allied health professional groups were compared with medicine, dentistry, and nursing for the periods 1970 to 1980 using data from the US census (1970 to 1980) and AMA Physician Masterfile. GINI indexes of health professionals concentration were computed as global measures to evaluate changes in the pattern of locational choice. All allied health professional groups reflected large percentage increases ranging from 25% to 432% in supply of practitioners from 1970 to 1980, with a median percentage increase of 71.9%, and compared well with medicine and dentistry. These allied health supply increases were generally related to better distributional outcomes among the general population and physicians, although several allied health groups became less evenly distributed during this decade. These gains were realized during a decade when less federal support was available for the allied health professions compared with medicine, dentistry, and nursing.

Multiskilled practitioners have been in health care settings for a long time. The form multiskilled practitioners have taken has varied with the cultural, socioeconomic, and technological constructs of the times. Some multiskilled practitioners have come and gone while others, such as the medical assistant and physician assistant, have remained. The complexity and sophistication of skills being combined have increased over time as have the degree level and opportunities for dual certification. Skills have been combined both across and within disciplines. There is currently a greater number and variety of formal programs to prepare multiskilled health practitioners in educational institutions and health care facilities, and more informal on-the-job training efforts than ever before--and they are increasing. Employment of multiskilled personnel has become a survival strategy for health care institutions in this current era of cost containment. Multiskilled allied health practitioners with basic nursing skills (ie, LPN level) may also provide one step toward a solution to the nursing personnel shortage being experienced by some health care facilities. The catchword for multiskilled has become not "whether," but "how."15 It is to everyone's benefit to learn from the efforts of those with experience in implementing the multiskilled health practitioner concept for both national and international application. The National Multiskilled Health Practitioner Clearinghouse intends, through its publications, services, and resource files, to serve as the cornerstone upon which the information from those with experience can be reposited and disseminated.

Noting the absence of unified data on the supply and demand of allied health practitioners in New York State, a study was conducted at the State University of New York at Stony Brook of 16 professional groups. The study consisted of a statewide census; a market survey of professional leaders, hospitals, long-term care facilities, and practicing professionals; and an analysis of educational programs available and minority enrollment in those programs. The results indicated that, in general, the supply and demand for the services of allied health professionals in New York State are in rough equilibrium, with some shortages in rural and inner-city locations. It was further noted that while the educational institutions are preparing adequate numbers of professionals to meet the employment demand, minority groups are significantly underrepresented in the enrollment figures.

The University of Texas Health Science Center at Dallas, School of Allied Health Sciences, has designed and established a linkage plan that could help solve the health personnel shortages in many cities. This plan joins several schools to (1) stimulate the implementation of programs to provide limited numbers of trained health professionals, (2) establish a coordinated system whereby technologists and technicians can be trained, (3) prepare qualified persons to staff the local hospitals, and (4) provide a ladder for advancing motivated and qualified health professionals. Coordination of efforts among the university, the seven-member Dallas Community College District, and the Dallas Independent School District's High School for Health Professions facilitates solid academic instruction at these institutions, which is followed by well-supervised clinical experiences in the local hospitals under highly qualified professionals. To date, the program includes the education of nuclear medicine technologists, radiation therapy technologists, electroencephalographic technologists, and histologic technicians. This mode of education is one solution to the health professional shortage.

This study examined the concept of the multicompetent practitioner - the health care worker trained in more than one specialty - as one way of meeting the changing needs of the health care system. Seventy-four hospital administrators, 74 directors of nursing, 14 directors of community health organizations, and 12 private physicians from the Philadelphia metropolitan area were surveyed to explore the feasibility of developing and using multicompetent practitioners at their participating institutions. The results indicated that multicompetent practitioners are already working in some institutions and that there is a willingness to hire this new type of health care worker. How the multicompetent practitioner fits into the institution, the level of education required beyond the original area of skill, and the question of salary were included in the survey. Findings also indicate positive support for the development of multicompetent practitioner training within allied health educational programs.

Three manpower projection methodologies most often employed in the allied health sciences were compared: population ratio, occupational matrix, and regression analysis. Comparisons were made among the methodologies themselves, their strengths, and their weaknesses. These methodologies were then applied to the largest allied health discipline - clinical laboratory sciences - using Kentucky statewide data. The resultant projections were then compared with actual data (F.J. Morris, PhD, unpublished data, 1985). The most appropriate methodology to be used by the administrator should be determined by his/her specific needs and goals in relation to the specific strengths and weaknesses of the individual methodology.