Retrospective analysis and future trends in allied health leadership and workforce: from therapy divisions to gig-economy aggregators

Dr Rosalie Boyce1,4, Professor Susan Nancarrow2, Dr Olivia King1, Dr Paul T. Jackway3

1University Hospital Geelong, Barwon Health & South West Healthcare, Geelong & Warrnambool, Australia, 2Southern Cross University, Gold Coast, Australia, 3NegInfinity Pty Ltd, Brisbane, Australia, 4University of Queensland, Brisbane, Australia

The development of ‘allied health’ has been accompanied by several shifts in public sector business models that have shaped the way allied health is organised. Each shift has had implications for both leadership and the workforce.

Drawing on a range of Australian and international secondary data sources and public documents we can trace distinct periods of evolution in allied health organisation and analyse their significance from a leadership and workforce perspective:

← Steady state stability and uniformity (< 1990s)

→ Outsourcing; External labour markets (> 1990s)

→ Social enterprise; Public private partnerships (2000s)

→ Complex multi-divisional geographic consolidation (2010s)

→ Gig-economy aggregators; Technology-driven platform proliferation.

We contend that the first three post-steady state phases for allied health have been accomplished through accommodation – with only moderate levels of upheaval and a focus on adjustment.

In contrast, the fourth phase (gig-economy) may be accompanied by more disruptive hallmarks arising from galloping “Uberisation” of app-based and telehealth service models as alternative offerings to traditional public sector care.

Predictions of allied health workforce loss due to AI and robotic substitution have been conservative. However, seismic disruption may come from gig-economy enabled approaches in which client preferences and an “on demand” culture dominate established profession-led practice easily able to be portrayed as staid and unresponsive to innovation.  In other words, models of ‘service’ trump models of ‘care’.  The public sector may also lose workforce to the attraction of highly flexible hours offered by gig-economy businesses; a known risk in highly feminised workforces such as allied health.

Public sector allied health leadership faces challenges because of its low expertise in countering gig-economy challenges and poor mastery of digital technology advances.  The paper will conclude with a discussion of:

(1)          identification of brand strengths associated with public sector allied health practice;

(2)          strategies to help minimise the potential loss of workforce, and

(3)          how to ignite leadership capability to lead in a digital future world.


Dr Rosalie Boyce (PhD) is an internationally recognised authority on management, organisation, workforce and leadership of the allied health professions. She has appointments as an Allied Health Research & Translation Lead (with Dr Olivia King) at University Hospital Geelong, Barwon Health / South West Healthcare; the University of Queensland and is Director of Rosalie Boyce Consulting Pty Ltd.

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