Patient portals and young people: addressing the privacy dilemma of providing access to health information.

Patient portals enable people to access their health information electronically, but concerns about confidentiality and privacy breaches, particularly for young people, may be impeding portal adoption in New Zealand. This paper considers the legal and ethical framework relating to health information privacy and informed consent in New Zealand, and proposes an approach to implementing patient portals for young people. Shared portal access (where both a young person and their parent or guardian have access to the young person's portal) may be appropriate for young children whose parents or guardians are responsible for their health care. However, as children mature and their capacity to make health care decisions increases, general practitioners will need to consider shifting to independent portal access by competent young people. The circumstances of each young person, including their best interests and rights, cultural needs and their views on information disclosure should be taken into account.

The rural medical generalist workforce: The Royal New Zealand College of General Practitioners' 2014 workforce survey results.

INTRODUCTION Previous surveys have revealed a New Zealand rural medical generalist workforce that is mainly male, older and dependent on international medical graduates (IMGs). AIMS To provide a snapshot of the New Zealand rural medical generalist workforce in 2014 and to make comparisons with the urban medical generalist workforce. To assess future workforce losses and find ways to address them. METHODS In March/April 2014, a survey of members of The Royal New Zealand College of General Practitioners used the SurveyMonkey tool. A comparative analysis was undertaken ofself-identified rural and urban respondents. RESULTS The response rate was 55.9% (2525/4514). Of the 2203 working respondents, 17.1% self-identified as rural, working in rural general practice or rural hospital medicine. Compared with urban respondents, more rural generalists were male (57.5% rural vs 45.5% urban; P < 0.01), aged ≥ 55 years (38.2% rural vs 32.6% urban; P = 0.04) and involved in teaching (53.0% rural vs 30.0% urban; P < 0.01). IMGs were an integral part of the rural generalist workforce (52.8% rural vs 38.7% urban; P < 0.01). More rural generalists worked ≥ 36 h per week (66.8% rural vs 50.4% urban; P < 0.01) and they were more likely to retire within the next 10 years (40.4% rural vs 34.7% urban; P = 0.0417). DISCUSSION The rural medical generalist workforce continues to be mainly male, older and consist of a high proportion of IMGs. Findings confirm the fragility of this workforce and highlight the need for renewed efforts to improve recruitment and retention.