National Institute for Health and Welfare, Helsinki, Finland.
Health Policy. 2013 Apr;110(1):22-8. doi: 10.1016/j.healthpol.2013.02.001. Epub 2013 Feb 26.
In many countries, public sector has major difficulties in recruiting and retaining physicians to work as general practitioners (GPs). We examined the effects of taking up a public sector GP position and leaving public sector GP work on the changes of job satisfaction, job involvement and turnover intentions. In addition, we examined whether organizational justice in the new position would moderate these associations. This was a four-year prospective questionnaire study including two measurements among 1581 (948 women, 60%) Finnish physicians. A change to work as a public GP was associated with a substantial decrease in job satisfaction and job involvement when new GPs experienced that their primary care organization was unfair. However, high organizational justice was able to buffer against these negative effects. Those who changed to work as public GPs had 2.8 times and those who stayed as public GPs had 1.6 times higher likelihood of having turnover intentions compared to those who worked in other positions. Organizational justice was not able to buffer against this effect. Primary care organizations should pay more attention to their GPs - especially to newcomers - and to the fairness how management behaves towards employees, how processes are determined, and how rewards are distributed.
在许多国家，公共部门在招聘和留住医生担任全科医生（GP）方面存在重大困难。我们研究了担任公共部门 GP 职位和离开公共部门 GP 工作对工作满意度、工作投入和离职意愿变化的影响。此外，我们还研究了新职位中的组织公平性是否会缓和这些关联。这是一项为期四年的前瞻性问卷调查研究，包括在 1581 名芬兰医生（948 名女性，60%）中进行的两次测量。当新的全科医生发现他们的初级保健组织不公平时，转为从事公共 GP 工作与工作满意度和工作投入大幅下降有关。然而，高组织公平性能够缓冲这些负面影响。与从事其他职位的医生相比，转为从事公共 GP 工作的医生有 2.8 倍和继续从事公共 GP 工作的医生有 1.6 倍的离职意愿。组织公平性无法缓冲这种影响。初级保健组织应该更加关注他们的全科医生——尤其是新员工——以及管理层对待员工的公平性、决策过程以及奖励分配方式。
