Workforce retention and attrition trends among optometrists in Australia: key factors and reasons.

Clinical relevance: Understanding workforce retention and attrition trends is needed to inform interventions that mitigate attrition and for planning.

Background: Retention and attrition are underexplored in optometry. The aim of this study was to identify factors and reasons underpinning decisions made by optometrists to remain in or leave the profession.

Methods: An online survey of optometrists registered with the Australian Health Practitioner Regulation Agency (AHPRA) as of 31 December 2023 and those who had not renewed in the preceding five years was conducted. In addition, a retrospective analysis of AHPRA registration data from 30 June 2014 to 30 June 2023 was undertaken.

Results: Out of 7,718 invited, 1,741 optometrists completed the survey (23% response rate). 79% indicated they intended to continue in the profession, 13% indicated they either intended to leave or were uncertain and the remainder were retired. Optometrists with non-practising registration had higher odds of intending to leave or feeling uncertain (OR = 17.65, 95% CI = [9.51, 32.78]), as did those aged over 60 years (OR = 3.13, 95% CI = [1.85, 5.28]). Reasons for intending to leave were: retirement; the work no longer being mentally stimulating, fulfilling or meaningful; unsatisfactory remuneration; and lack of career advancement opportunities. Registration data showed a 22.8% increase in the number of optometrists per 100,000 population, from 19.7 to 24.2. Replacement rate peaked in 2020, before a large decline in 2022 attributable to an increase in the over 60 years and the 35-60 years age groups leaving the profession.

Conclusion: Although there has been considerable growth in the number of optometrists per population over the past decade, the replacement rate has declined recently due to an increase in optometrists leaving the profession. Strategies to mitigate attrition may include attractive remuneration, flexible work arrangements and a varied workload that offers professional stimulation. Attrition and the reasons for it require ongoing monitoring.