Abstract: The challenges of recruitment and retention of health professionals in rural and remote Australia are well documented. Increases in need arising from an ageing population and the burden of chronic disease, together with a decrease in workforce supply globally, creates further challenges in rural and remote areas where high turnover is frequently reported. This research focuses on rural and remote managers, and seeks to understand where improvements in management practices can have the greatest impact in improving health workforce retention. Social Exchange Theory proposes that where there are effective employee-manager workplace relationships and where there is perceived organisation support from the employee’s perspective, organisations will observe improvements in retention, as well as improvements across a range of performance indicators. Hence, there are many benefits that arise from an effective employee-manager employment relationship. This research examined the words that health professionals and managers use to describe what it is like to work in rural/remote northern Australia. The aim of the study was to identify if similarities and differences in manager and health professional’s perceptions provide opportunities to improve retention through effective employee-manager relationships. This qualitative research study used a purposive sampling method to recruit participants who were either managers or health professionals working in rural/remote regions of northern Australia. Twenty-four semi-structured interviews were conducted in-person or via telephone depending on the participant’s location. Participants were asked to provide five words that best described working in a rural/remote community from their perspective and then from the alternative perspective. That is, health professionals in rural/remote areas described their work experience and then how they perceived that their manager would describe it. Managers described it from their perspective and then how they perceived that a remote health professional would describe it. The research found opportunities to improve retention through the similarities and differences in each group’s perceptions about working in rural and remote northern Australia. Few managers hesitated in describing the health professionals’ perspective, yet many health professions paused and contemplated whether their manager really understood what it is like to work in rural and remote regions. This research provides evidence not that there are differences and similarities; it provides language around where these similarities and differences emerge enabling opportunities to further explore where these misaligned perceptions may be translating into unrealised potential and poor retention of otherwise competent and passionate health professionals.