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Aims and methodTo describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted.ResultsMetabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a ‘good doctor’ supported comprehensive follow-up.Clinical implicationsPsychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice.

Aims and methodTo describe and explain psychiatrists' responses to metabolic abnormalities identified during screening. We carried out an audit of clinical records to assess rates of monitoring and follow-up practice. Semi-structured interviews with 36 psychiatrists followed by descriptive and thematic analyses were conducted.ResultsMetabolic abnormalities were identified in 76% of eligible patients screened. Follow-up, recorded for 59%, was variable but more likely with four or more abnormalities. Psychiatrists endorse guidelines but ambivalence about responsibility, professional norms, resource constraints and skills deficits as well as patient factors influences practice. Therapeutic optimism and desire to be a ‘good doctor’ supported comprehensive follow-up.Clinical implicationsPsychiatrists are willing to attend to physical healthcare, and obstacles to recommended practice are surmountable. Psychiatrists seek consensus among stakeholders about responsibilities and a systemic approach addressing the social determinants of health inequities. Understanding patients' expectations is critical to promoting best practice.

Objective: To evaluate Queensland Health's recruitment campaign of 15 full-time psychiatrists to non-metropolitan areas between July 1992 and December 1993.Method: A detailed 170-item Likert-type questionnaire was designed and mailed to all 15 psychiatrists. Thirteen questionnaires were completed and followed-up by a face to face interview.Results: Findings indicate that most of those recruited were experienced senior specialists who came to the positions as result of personal contact and were attracted to non-metropolitan positions because of ‘lifestyle’ and ‘professional challenge’ variables. ‘Lifestyle’ and ‘professional’ variables were identified as major contributors to their retention. They reported that ‘bureaucracy’ and ‘social and family’ reasons would be the most likely cause of them considering leaving their current positions.Conclusions: While the recruitment campaign was evaluated as successful, some aspects were clearly more influential than others. It was noted that factors which were likely to influence psychiatrists to leave non-metropolitan public sector positions were more ‘public’ than ‘non-metropolitan’ in nature.

There is a major geographical maldistribution and shortage of psychiatrists throughout Queensland. In June 1992, 48 psychiatrists worked outside of Brisbane where 66% of the population reside, while 172 psychiatrists worked in the metropolitan area. The reasons for and the effects of the maldistribution are discussed. Since 1991, Queensland Health has developed a number of key strategies to attract and retain psychiatrists in our non-metropolitan areas. These strategies are outlined. Between July 1992 and December 1993, 14 new full time psychiatrists were recruited. The results of these strategies are encouraging.

There is a major geographical maldistribution and shortage of psychiatrists throughout Queensland. In June 1992, 48 psychiatrists worked outside of Brisbane where 66% of the population reside, while 172 psychiatrists worked in the metropolitan area. The reasons for and the effects of the maldistribution are discussed. Since 1991, Queensland Health has developed a number of key strategies to attract and retain psychiatrists in our non-metropolitan areas. These strategies are outlined. Between July 1992 and December 1993, 14 new full time psychiatrists were recruited. The results of these strategies are encouraging.

Objective: To evaluate Queensland Health's recruitment campaign of 15 full-time psychiatrists to non-metropolitan areas between July 1992 and December 1993.Method: A detailed 170-item Likert-type questionnaire was designed and mailed to all 15 psychiatrists. Thirteen questionnaires were completed and followed-up by a face to face interview.Results: Findings indicate that most of those recruited were experienced senior specialists who came to the positions as result of personal contact and were attracted to non-metropolitan positions because of 'lifestyle' and 'professional challenge' variables. 'Lifestyle' and 'professional' variables were identified as major contributors to their retention. They reported that 'bureaucracy' and 'social and family' reasons would be the most likely cause of them considering leaving their current positions.Conclusions: While the recruitment campaign was evaluated as successful, some aspects were clearly more influential than others. It was noted that factors which were likely to influence psychiatrists to leave non-metropolitan public sector positions were more 'public' than 'non-metropolitan' in nature.