Workplace relational factors and physicians' intention to withdraw from practice

Health Care Manage Rev. 2008 Apr-Jun;33(2):178-87. doi: 10.1097/01.HMR.0000304507.50674.28.


Background: Physician turnover threatens continuity of care for patients and is a huge expense for health care organizations. Health care organizations have been advised to help physicians build positive relations with colleagues, staff, and patients as a strategy to socially integrate physicians in the workplace and to increase physician retention. Although these recommendations are touted as "evidence-based" practices, the importance of workplace relationships for physician retention has not been established empirically.

Purpose: The purpose of this study is to examine two questions: Are physicians who report better relationships with colleagues, staff, and patients less likely to intend to withdraw from practice? Do the effects of these relational factors differ for large-group and solo/small-group practice physicians?

Methodology: Using data from the Physician Worklife Survey, we analyzed the associations between physicians' reported relationships with colleagues, staff, and patients and intention to withdraw from practice within 2 years using logistic regression.

Findings: : Relationships with colleagues had a significant and negative association with intended withdrawal from practice for large-group practice physicians. The joint effect of relationships with colleagues, staff, and patients was significant for large-group practice physicians, but it only approached significance for solo/small-group practice physicians.

Practice implications: This study suggests that workplace relationships may influence physicians' intention to withdraw from practice, but the mechanisms by which they do so are unclear. Possible interventions to improve physician retention include promotion of informal mentoring and efforts to support community involvement of physicians and their families. Further research examining the role of these and other programs in promoting physician retention can help employers to foster positive workplace relationships and improve retention.

MeSH terms

  • Adult
  • Female
  • Group Practice
  • Health Care Surveys
  • Humans
  • Intention*
  • Interprofessional Relations*
  • Job Satisfaction
  • Logistic Models
  • Male
  • Middle Aged
  • Personnel Loyalty*
  • Personnel Turnover / economics
  • Physicians / psychology*
  • Private Practice
  • United States
  • Workplace*