On-call work and physicians’ turnover intention: the moderating effect of job strain

Physician shortage and turnover are major problems worldwide. On-call duties may be among the risk factors of high turnover rates among physicians. We investigated whether having on-call duties is associated with physicians’ turnover intention and whether job strain variables moderate this association. The present study was a cross-sectional questionnaire study among 3324 (61.6% women) Finnish physicians. The analyses were conducted using analyses of covariance adjusted for age, gender, response format, specialization status and employment sector. The results showed that job strain moderated the association between being on-call and turnover intention. The highest levels of turnover intention were among those who had on-call duties and high level of job strain characterized by high demands and low control opportunities. The lowest levels of turnover intention were among those who were not on-call and who had low strain involving low demands and high control. Also, job demands moderated the association between being on-call and turnover intention; turnover intention levels were higher among those with on-call duties and high demands than those being on-call and low demands. To conclude, working on-call was related to physicians’ turnover intention particularly in those with high job strain. Health care organizations should focus more attention on working arrangements and scheduling of on-call work, provide a suitable working pace and implement means to increase physicians’ participation and control over their job.     

Does young adults’ preferred role in decision making about health,money, and career depend on their advisors’ leadership skills?

Few empirical data exist on how decision making about health differs from that in other crucial life domains with less threatening consequences. To shed light on this issue we conducted a study with 175 young adults (average age 19 years). We presented the participants with scenarios involving advisors who provided assistance in making decisions about health, money, and career. For each scenario, participants were asked to what extent they wanted the advisor to exhibit several leadership styles and competencies and what role (active, collaborative, or passive) they preferred to play when making decisions. Results show that decision making about health is distinct from that in the other domains in three ways. First, most of the participants preferred to delegate decision making about their health to their physician, whereas they were willing to collaborate or play an active role in decision making about their career or money. Second, the competencies and leadership style preferred for the physician differed substantially from those desired for advisors in the other two domains: Participants expected physicians to show more transformational leadership—the style that is most effective in a wide range of environments—than those who provide advice about financial investments or career. Finally, participants’ willingness to share medical decision making with their physician was tied to how strongly they preferred that the physician shows an effective leadership style. In contrast, motivation to participate in decision making in the other domains was not related to preferences regarding advisors’ leadership style or competencies. Our results have implications for medical practice as they suggest that physicians are expected to have superior leadership skills compared to those who provide assistance in other important areas of life.