Identification of native physicians retention components in Iranian health system: A mixed method study

Abstract

Background: Physicians and health professionals are the cornerstone of health systems and play an indelible role in promoting the health of each community. As mentioned by the World Bank, human capital, particularly elites and highly skilled human resources, is the wealth of countries. Maintaining and preserving them is the prerequisite of sustainable development of the health sector, availability, and quality of health services. Objectives: The main purpose of this study was to identify the effective key variables in the retention of native Iranian physicians and preventing their migration abroad. Methods: This study was conducted using a mixed-method approach based on a sequential exploratory strategy in 2018. In the qualitative section, semi-structured interviews were conducted with 36 faculty members of Shiraz University of Medical Sciences (SUMS). The theoretical saturation was reached via a purposeful sampling and maximum variation by applying conventional thematic analysis method processes. In the quantitative section, a questionnaire was developed, and its validity and reliability were tested and verified. The questionnaire was distributed among a random sample of 158 physicians out of a target population of 283 first-year medical assistants at SUMS. In addition, the data were reviewed by applying a descriptive-survey method, and thematic analysis was used to analyze the data. Results: In total, 60 basic themes, 9 organizing themes, and one global theme were extracted. The strong educational management base for the educational support theme with a factor of 0.91 (P < 0.001) was the best descriptor in the physicians’ preservation model. Conclusions: The following critical variables affect the native physicians’ retention: effective and strong medical education administration as educational support, flexible working hours, availability of complete labor market information, emphasis and attention to creativity and scientific, and research innovations in the medical profession. © 2020, Author(s).