Greener pastures here or abroad? You decide.

The shortage of experienced and specialised allied health professionals has been causing a stir in Australia recently, with many organisations unable to find the qualified staff that they need.

Every day, I speak with Physiotherapists, Occupational Therapists and Speech Pathologists who have decided to go abroad in search of greener pastures, or simply to gain experience in a new healthcare system. But how have these healthcare professionals fared? Have they found any major differences between working as a health professional here in Australia vs. abroad?

I have recently asked some allied health professionals who have worked in Australia and in other countries to share their thoughts with me. Here is what they had to say.

A.C, Physiotherapist – Australia and New Zealand

A.C, Physiotherapist, has worked in Australia and in New Zealand across a range of different settings. A.C. commented on a few main areas.

-       It is relatively easy to get professional registration via Trans-Tasman Mutual Recognition if you have clean registration history in either country.

-       Regarding remuneration, A.C. reports that private sector work varies a bit but the public sector pays significantly less in New Zealand. Groceries and fuel being as expensive as they are made him grateful he worked in the private sector with a company car/fuel card.

-       A.C.  notes far more acknowledgement and training of Maori cultural health perspectives/needs across the country compared to incorporation of indigenous health needs in Australia.

-       He also reported that superannuation in New Zealand is also fairly new relative to Australia and is not as attractive. He couldn't transfer his Kiwi super to his Australian fund readily either - none of the Australian funds he contacted at the time last year would do it.

C.B, Occupational Therapist – Australia and the United Kingdom

C.B has spent time working in Australia and the UK. C.B went to the UK as a grade 1 therapist/band 5 therapist who had some Australian experience prior to leaving. She shared her views on new graduates entering the workforce in the UK.

-       C.B thinks that the transition from university to the workforce in Australia is much smoother than in the UK. She thinks that a lot of the learning is done on the job in the UK, however in a winter rush it's not cost effective or efficient. She thinks that the Senior Occupational Therapists are very knowledgeable so it all evens out in the end, but the supervision required for a newly qualified band 5 is not realistic in a busy winter period in a hospital, and in turn they are not getting the supervision that is probably needed.

C.K, Physiotherapist – Spain and Australia

C.K has worked between Australia and Spain for a few years. She is currently practising in private practice in Spain and there are a few things that she was keen to share her views on.

-       The biggest cultural difference is the timetable. First, you have to get used to dinner being at 22:00 or 23:00 as a normal thing. Work wise, the region of Catalonia in Spain (and most of Spain itself) has a "migdiada" in Catalan or "siesta" in Spanish where you break for 3-5 hours in the middle of the day! So, your timetable might be for example from 9:00 to 13:00 then from 16:00 to 20:00.

-       Physiotherapists are paid an above average salary in Spain, but it is around half the amount you would be paid in Australia. This is because the cost of living is so cheap in Spain. Hop across the border to France and the pay for a Physiotherapist is significantly more. As for the price of living in France, she is not sure. 

-       Private practice is generally one of two things - sports specialists only or doctor referral only practices. In the sports specialist practices there is a big emphasis on multidisciplinary input with nutritionists, exercise physiologists and biochemical analysis (blood testing). Usually people present to these types of practices with niggles and seeking to improve and optimise themselves in their respective sports. The other type of practice involves having the patient being referred by a doctor with a diagnosis. There is still primary contact here, as in anyone can book in with a physiotherapist, but it’s not that common. The doctor’s referral will usually tell you exactly what they want to be done and sometimes they will include the investigations that have been completed

-       Coming from Australia, it’s clear after practicing some years in Spain that as a country it does not use evidence-based practice model that we do in Australia. Physiotherapists here are still heavily using ultrasound for pain and passive stretching and infra-red light for muscular contracture. That doesn't mean you have to use these modalities as a therapist here, but it’s something that can be culturally relevant when practicing in Spain. 

J.W, Occupational Therapist – New Zealand and Australia

J.W came to Australia to complete a locum position in aged-care through MARS Recruitment. J.W had some positive reports on her experience coming to Australia as a locum Occupational Therapist.

-       It is very straight forward to get Trans-Tasman Mutual agreement if you are a New Zealand registered Occupational Therapists transferring over to AHPRA.

-       Coming to Australia as a locum therapist gives Occupational Therapists an opportunity to potentially try out a new area of practice using their OT skills but in different area which sometimes can be a hard change. The company that J.W worked with offered lots of online professional development opportunities, which was a welcome surprise for her being a locum employee.

-       They money is good (compared to NZ for relatively new grad/ a few years’ experience)

-       Coming from a different country, it can take a while to pick up on some contextual information- funding and policy, way of future healthcare.

-       Having an agency at hand assisted with a ‘comforting’/ reassuring to move from NZ over to Australia as she felt like she always had a backup or ‘union’ of sorts to help her out.

E.K, Speech Pathologist – United Kingdom and Australia

E.K came to Australia on a working holiday visa. She has worked in hospital settings both here and in the UK and found pros and cons in both locations.

-       E.K found the various approaches to MDT different. It was a structured approach in the UK where SLTs and all AHPs were well represented and respected in most clinical areas. She found it varied in Sydney, (e.g. a number of MDT meetings focused primarily on medical management and discharge planning) and most were not recorded in notes (versus holistic, goal focused MDTs with written templates in the UK, often led by AHPs as opposed to medics - particularly in stroke care).  Furthermore, in the UK there was a big focus on MDT meetings with families for care decisions and discharge planning (particularly if a patient was going for a new care home placement) this was not often standard practice in Sydney.

-       AHPs and all medical professionals in the UK were responsible to conduct mental capacity assessments (decision specific) with patients, again structured documentation was required, there was a big focus on it. E.K. found there wasn't as much of a focus on it in Sydney.

-       She found the ecteronic medical records in Australia far more efficient and experienced good IT systems in general e.g. eMR communicates with the journey boards, referral systems for imaging, AHP referrals etc (she used to operate 10+ systems in the UK which did not communicate with each other in comparison). 

-       She was really impressed with CPD opportunities available in Australia and the good managerial support to access a variety of CPD opportunities internally/externally. She was also pleasantly surprised with the amount of opportunities she had as a locum (and doesn’t think it is the same for locums in the UK)

-       E.K reports that throughout her time in Australia, there was a good focus on quality improvement within departments, both Speech Pathology related and some joint QI projects with other AHPs, and a strong focus on evidence-based practice with regular reflections on how to improve practice and audits e.g. with Redcap

-       She thought that there was a good work-life balance here in Australia with an evident focus on leaving on time, taking lunch breaks, ADOs for full-time staff, strong support from management to take annual leave for extended periods for travels etc. She also noted that teams where she worked tended to be social and most departments have their own social club. 

There are lots of allied health professionals leaving Australia in search of better jobs and healthcare systems but I think it is clear that the grass isn’t always greener on the other side (and the same can be said for those coming this way too!).

To all of you Australian health professional who are abroad – what will it take to get you back? How have you fared abroad? And what kind of changes would you like to see in the Australian system?

We have a range of different opportunities available all over the country at the moment. If you would like to see what is available here at the moment, feel free to get in touch with me on (02) 9003 4935 or [email protected]