Abstract
BackgroundPhysician shortage has become an urgent and critical challenge to many countries. According to the workforce dynamic model, long work hours may be one major pressure point to the attrition of physicians. Financial incentive is a common tool to human power retention. Therefore, this large-scale physician study investigated how pay satisfaction may influence the relationship between work hours and hospital physician’s turnover intention.MethodsData were obtained from a nationwide survey of full-time hospital staff members working at 100 hospitals in Taiwan. The analysis sample comprised 2423 full-time physicians. Dependent variable was degree of the physicians’ turnover intention to leave the current hospital. The pay satisfaction was assessed by physicians themselves. We employed ordinal logistic regression models to analyze the association between the number of work hours and turnover intention. To consider the cluster effect of hospitals, we used the “gllamm” command in the statistical software package Stata Version 12.1.ResultsThe results show that 351 (14.5%) of surveyed physicians reported strong intention to leave current hospital. The average work hours per week among hospital physicians was 59.8 h. As expected, work hours exhibited an independent relationship with turnover intention. More importantly, pay satisfaction could not effectively moderate the positive relationship between work hours and intentions to leave current hospital.ConclusionsThe findings show that overtime work is prevalent among hospital physicians in Taiwan. Both the Taiwanese government and hospitals must take action to address the emerging problem of physician high turnover rate. Furthermore, hospitals should not consider relying solely on financial incentives to solve the problem. This study encouraged tackling work hour problem, which would lead to the possibility of solving high turnover intention among hospital physicians in Taiwan.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1916-2) contains supplementary material, which is available to authorized users.
Highlights
Physician shortage has become an urgent and critical challenge to many countries
Regarding the categories for the number of work hours per week, 1102 (45.5%) of the physicians worked more than 60 h, and 207 (8.5%) physicians worked more than 88 h
The medical centers and regional hospitals where physician shortages were the most serious in Taiwan were included in the sample
Summary
Physician shortage has become an urgent and critical challenge to many countries. According to the workforce dynamic model, long work hours may be one major pressure point to the attrition of physicians. Financial incentive is a common tool to human power retention. This large-scale physician study investigated how pay satisfaction may influence the relationship between work hours and hospital physician’s turnover intention. The workforce dynamic model, proposed by Sklar, suggests three phase of physician workforce dynamic and their various pressure points to which interventions can target [4]. Rapid changes in health care environments and increasing health care costs have led to great pressures on physicians. Hospital physicians may be susceptible to these factors because of the nature and environment of their work.
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