The Shocking Cost of Turnover in Health Care

Waldman, J. Deane; Kelly, Frank L.; Aurora, Sanjeev; Smith, Howard L.

doi:10.1097/00004010-200401000-00002

Cited by 428 publications

(366 citation statements)

References 5 publications

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Section: Discussionmentioning

confidence: 99%

“…5,[49][50][51] In the early 2000s, the estimated cost of replacing a physician who left a practice was $250,000, and faculty turnover costs accounted for 5% of the annual budget in one academic health center. 50,51 Furthermore, the Council on Graduate Medical Education predicted a substantial shortfall of physicians by 2020. 52 Our study suggests that career commitment might be improved by cultivating a sense of vocational identity (e.g., a sense of calling) while promoting a work environment in which physicians experience their work as being personally rewarding.…”

Section: Discussionmentioning

confidence: 99%

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Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

2017

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BACKGROUND: Although intrinsic motivating factors play important roles in physician well-being and productivity, most studies have focused on extrinsic motivating factors such as salary and work environment. OBJECTIVE: To examine the association of intrinsic motivators with physicians' career satisfaction, life satisfaction, and clinical commitment, while accounting for established extrinsic motivators as well. DESIGN AND PARTICIPANTS: A nationally representative survey of 2000 US physicians, fielded October to December 2011. MAIN MEASURES: Outcome variables were five measures of physician well-being: career satisfaction, life satisfaction, high life meaning, commitment to direct patient care, and commitment to clinical practice. Primary explanatory variables were sense of calling, personally rewarding hours per day, meaningful, long-term relationships with patients, and burnout. Multivariate logit models with survey design provided nationally representative individual-level estimates. KEY RESULTS: Among 1289 respondents, 85.8% and 86.5% were satisfied with their career and life, respectively; 88.6% had high life meaning; 54.5% and 79.5% intended to retain time in direct patient care and continue clinical practice, respectively. Sense of calling was strongly positively associated with high life meaning (odds ratio [OR] 5.14, 95% confidence interval [95% CI] 2.87-9.19) and commitment to direct patient care (OR 2.50, 95% CI 1.53-4.07). Personally rewarding hours per day were most strongly associated with career satisfaction (OR 5.28, 95% CI 2.72-10.2), life satisfaction (OR 4.46, 95% CI 2.34-8.48), and commitment to clinical practice (OR 3.46, 95% CI 1.87-6.39). Long-term relationships with patients were positively associated with career and life satisfaction and high life meaning. Burnout was strongly negatively associated with all measures of physician wellbeing. CONCLUSIONS: Intrinsic motivators (e.g., calling) were associated with each measure of physician well-being (satisfaction, meaning, and commitment), but extrinsic motivators (e.g., annual income) were not associated with meaning or commitment. Understanding the effects of intrinsic motivators may help inform efforts to support physician well-being.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

2017

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“…Workplace bullying has been found to be a significant predictor of turnover (Begley, 1998), which incurs substantial costs for the organisation (Waldman, Kelly, Arora & Smith, 2004). Workplace bullying has widespread negative effects on organisations because it affects not only the targets but also those who witness bullying behaviour.…”

Section: Bullying and Turnover Intentionmentioning

confidence: 99%

The moderating role of perceived organisational support in the relationship between workplace bullying and turnover intention across sectors in South Africa

Schalkwyk¹,

Els²,

Rothmann

2011

SA j. hum. resour. manag.

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Orientation: Because workplace bullying has detrimental consequences on the profitability, work quality and turnover intention of organisations, this phenomenon should be addressed. Perceived Organisational Support (POS) was explored since factors such as role clarity, job information, participation in decision-making, colleague support and supervisory relationships might act as buffers against workplace bullying, subsequently influencing the turnover intention of the organisation.Research purpose: To investigate the role of POS as moderator in the relationship between workplace bullying and turnover intention across sectors in South Africa.Motivation for the study: Workplace bullying is a worldwide concern and it is unclear whether perceived organisational support moderates the relationship between workplace bullying and turnover intention.Research design, approach and method: A cross-sectional survey approach with a quantitative research design was used (N = 13 911). The South African Employee Health and Wellness Survey (SAEHWS) was administered to explore the experiences of bullying behaviour, POS and turnover intention.Main findings: Bullying by superiors is more prevalent than bullying by colleagues. A positive relationship exists between workplace bullying and turnover intention. Role clarity, participation in decision-making and supervisory relationship moderates the relationship between bullying by superiors and turnover intention.Practical/managerial implications: This study creates an awareness of the prevalence of workplace bullying in the South African context so that sufficient counteraction can be encouraged.Contribution/value-add: This study contributes to the limited research regarding workplace bullying in the South African context by quantifying the relationships between workplace bullying POS and turnover intention.How to cite this article: Van Schalkwyk, L., Els, C., & Rothmann, S. (Jr). (2011). The moderating role of perceived organisational support in the relationship between workplace bullying and turnover intention across sectors in South Africa. SA Journal of Human Resource Management/SA Tydskrif vir Menslikehulpbronbestuur, 9(1), Art. #384, 13 pages. http://dx.doi.org/10.4102/sajhrm.v9i1.384

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“…Frustration with productivity, career advancement, as well as balancing the gastroenterology career and family responsibilities may contribute to a female faculty member's decision to leave a faculty position [1]. This dissatisfaction of the female physician has become an important economic problem for academic medical centers since replacing a faculty member could cost an institution $115,000-$400,000 [10].…”

Section: Gender Responsibilities and Academic Gastroenterologymentioning

confidence: 99%

Women Gastroenterologists in Academic Medicine: Tradition Versus Transition

2016

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Most women experience childhood dreams of being a grownup, with a pretty house with a white picket fence and children running around. That same little girl wanted to be a doctor; she grew up and had to face the reality that life is more complex than her dreams and that being a female gastroenterologist in this era is a multifaceted endeavor. Gastroenterology as a specialty offers the opportunity to provide long-term care to our patients and enjoy the technical aspects of endoscopy and other procedures. Until as recently as 1990, fewer than 5% of gastroenterologists were women, possibly due to the perception at the time that the practice of gastroenterology was associated with long and irregular hours, frequent night call, harsh physical strength, and quite frankly, working with aesthetically challenging bodily emanations. Recently, when more women started to consider gastroenterology as a subspecialty, there was also increased interest by women in technology, a gender shift that may reflect changes in women's places in society. Nevertheless, since gastroenterology remains a physically and intellectually demanding subspecialty, conflicts between personal and career goals arise as women transition from fellowship to practice. It is expected that as women struggle to balance family and career, the discovery of new approaches to traditional women's contributions toward academic gastroenterology and career pathways is warranted.

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The Shocking Cost of Turnover in Health Care

Cited by 428 publications

References 5 publications

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

Association of Intrinsic Motivating Factors and Markers of Physician Well-Being: A National Physician Survey

The moderating role of perceived organisational support in the relationship between workplace bullying and turnover intention across sectors in South Africa

Women Gastroenterologists in Academic Medicine: Tradition Versus Transition

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