Should I stay or should I go now? The impact of "pull" factors on physician decisions to remain in a destination country.

Abstract

The recruitment and retention of a competent health care workforce is a worldwide problem. Globalization and increased mobility have provided skilled clinicians the freedom to offer their services in an interconnected global employment market, with multiple studies revealing a pattern of migration from low- and middle-income countries to high-income countries in North America, Western Europe, and more recently, the Middle East. The purpose of this study is to review the United Arab Emirates health care man power strategy and to assess the impact of pull factors on physician retention plans. The study employed a mixed-method comparative approach, comprising a comprehensive review of the literature on human resources for health issues and physician migration patterns, along with a cross sectional survey of expatriate physicians working in private and public sectors in the United Arab Emirates (UAE) between November 2018 and March 2019. Of 479 physicians, 374 participated (79% response rate). Issues related to family and social life encouraged remaining in the UAE, including close proximity to extended family, social environment, and spouse's employment opportunities. The government's new policy to provide 10-year visas to health professionals was perceived as an important factor encouraging retention. Only 35% of respondents felt that their income was an important factor in deciding to remain in the UAE. Significant gender differences exist in physician migration decisions. Factors influencing retention of the UAE's expatriate physician workforce are primarily lifestyle-related. Physicians also report positive perceptions of newly implemented visa policies.