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‘Should I stay or should I go now?’: A qualitative study of why UK doctors retire

‘Should I stay or should I go now?’: A qualitative study of why UK doctors retire
‘Should I stay or should I go now?’: A qualitative study of why UK doctors retire

Objectives: Health care delivery and education face critical potential shortages in the foreseeable future in terms of retaining doctors nearing the time of retirement - doctors who have experience-based knowledge to pass onto the next generation. Retirement decisions are driven by a combination of macro-related, job and individual factors. This is a constantly shifting space; findings from earlier studies do not always help us understand the retirement decisions of contemporary cohorts of doctors. To address these issues, and identify new knowledge to inform approaches to retaining expertise, we aimed to identify and explore what may keep an older doctor in the workforce (‘stay’) factors and (‘go’) factors that might prompt retirement. Methods: We invited doctors aged 50 years or over from diverse areas of Scotland to participate in qualitative, semi-structured interviews. Initial analysis of interview transcripts was inductive. The embeddedness theory of Mitchell et al encompassing the dimensions of ‘link,’ ‘fit’ and ‘sacrifice,’ was used for subsequent theory-driven analysis. Results: A total of 40 respondents participated. In terms of ‘link,’ retiring could feel like a loss when work links were positive, whereas the opposite was true when relationships were poor, or peers were retiring. Considering ‘fit,’ intrinsic job satisfaction was high but respondents had less confidence in their own abilities as they grew older. However, the data foregrounded the inverse of the notion of Mitchell et al's ‘sacrifice’; for UK doctors, staying in work can involve sacrifice because of tax penalties, work intensity and arduous demands. Conclusions: Retirement stay and go factors seem enmeshed in the cultural, social and economic structures of health care organisations and countries. Systems-level interventions that address ultimate causes, such as sufficient staffing, supportive systems, non-punitive taxation regimes and good working conditions are likely to be most effective in encouraging doctors to continue to contribute their knowledge and skills to the benefit of patients and learners.

0308-0110
821-831
Cleland, Jennifer
336c72d9-e6c3-4e16-9b57-bb9e74cfdaac
Porteous, Terry
fa6715dc-6625-4333-a84f-f9bb348c7a18
Ejebu, Ourega-Zoé
4f545ae3-4823-44ab-8d59-185d30929ada
Skåtun, Diane
5ced1e86-4238-48da-9c9a-9cdce93e3e89
Cleland, Jennifer
336c72d9-e6c3-4e16-9b57-bb9e74cfdaac
Porteous, Terry
fa6715dc-6625-4333-a84f-f9bb348c7a18
Ejebu, Ourega-Zoé
4f545ae3-4823-44ab-8d59-185d30929ada
Skåtun, Diane
5ced1e86-4238-48da-9c9a-9cdce93e3e89

Cleland, Jennifer, Porteous, Terry, Ejebu, Ourega-Zoé and Skåtun, Diane (2020) ‘Should I stay or should I go now?’: A qualitative study of why UK doctors retire. Medical Education, 54 (9), 821-831. (doi:10.1111/medu.14157).

Record type: Article

Abstract

Objectives: Health care delivery and education face critical potential shortages in the foreseeable future in terms of retaining doctors nearing the time of retirement - doctors who have experience-based knowledge to pass onto the next generation. Retirement decisions are driven by a combination of macro-related, job and individual factors. This is a constantly shifting space; findings from earlier studies do not always help us understand the retirement decisions of contemporary cohorts of doctors. To address these issues, and identify new knowledge to inform approaches to retaining expertise, we aimed to identify and explore what may keep an older doctor in the workforce (‘stay’) factors and (‘go’) factors that might prompt retirement. Methods: We invited doctors aged 50 years or over from diverse areas of Scotland to participate in qualitative, semi-structured interviews. Initial analysis of interview transcripts was inductive. The embeddedness theory of Mitchell et al encompassing the dimensions of ‘link,’ ‘fit’ and ‘sacrifice,’ was used for subsequent theory-driven analysis. Results: A total of 40 respondents participated. In terms of ‘link,’ retiring could feel like a loss when work links were positive, whereas the opposite was true when relationships were poor, or peers were retiring. Considering ‘fit,’ intrinsic job satisfaction was high but respondents had less confidence in their own abilities as they grew older. However, the data foregrounded the inverse of the notion of Mitchell et al's ‘sacrifice’; for UK doctors, staying in work can involve sacrifice because of tax penalties, work intensity and arduous demands. Conclusions: Retirement stay and go factors seem enmeshed in the cultural, social and economic structures of health care organisations and countries. Systems-level interventions that address ultimate causes, such as sufficient staffing, supportive systems, non-punitive taxation regimes and good working conditions are likely to be most effective in encouraging doctors to continue to contribute their knowledge and skills to the benefit of patients and learners.

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More information

Accepted/In Press date: 11 March 2020
e-pub ahead of print date: 17 March 2020
Published date: 1 September 2020
Additional Information: © 2020 Association for the Study of Medical Education and John Wiley & Sons Ltd.

Identifiers

Local EPrints ID: 445302
URI: http://eprints.soton.ac.uk/id/eprint/445302
ISSN: 0308-0110
PURE UUID: 244ea476-464a-4aef-aa47-9fbc83313eff
ORCID for Ourega-Zoé Ejebu: ORCID iD orcid.org/0000-0003-0608-5124

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Date deposited: 02 Dec 2020 17:31
Last modified: 28 Apr 2022 02:31

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Contributors

Author: Jennifer Cleland
Author: Terry Porteous
Author: Diane Skåtun

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