Sex-stratified analysis of factors associated with attrition intent from the General Internal Medicine physician workforce in Switzerland

BackgroundThe healthcare sector has a shortage of physicians. Strategies to better retain medical professionals in the workforce in General Internal Medicine must rely on an in-depth understanding of factors associated with wanting to quit their job. Here, we investigated sex-specific associations of workplace-related and personal factors associated with wanting to quit work among physicians. MethodsIn a cross-sectional questionnaire among physicians working in General Internal Medicine in Switzerland, we assessed personal and workplace-related factors in association with the desire to quit their job. The outcome variable of wanting to quit ones job was dichotomized from a 6-point Likert scale. We performed sex-stratified analyses by Wilcoxon rank sum test, Chi-square test and multiple logistic regression adjusting for demographic variables. ResultsThis study included 682 physicians, 278 (41%) men and 404 (59%) women aged 37{+/-}11 years (mean {+/-} standard deviation). A majority of 78% men and 75% worked in hospitals. Overall, a desire to quit their job was prevalent in 33% of respondents of either sex. Almost all workplace-related items were associated with the probability of wanting to quit among both sexes: Having a good network, mentoring or supervisors support were associated with a lower probability of wanting to quit, whereas having a bad work-life balance or dissatisfaction with autonomy at work. Problematic or workplace inclusiveness and experienced gender-related discrimination at work were associated with a higher probability of wanting to quit in univariable analysis in both sexes. The main sex difference was that the associations of workplace inclusiveness or gender discrimination with wanting to quit were robust to adjustment by type of workplace and language region in men, whereas in women upon multivariable adjustments the associations disappeared. Finally, in men (but not women) having no adequate childcare was more likely to desire quitting their job. ConclusionThis study identified several factors of which some may exert a causal relationship with the desire to quit a physician job. Modifying such factors by interventions may ultimately increase the likelihood of a physician continuing working in his profession.