Factors Influencing Turnover Intention of Physicians in Deprived Areas

Background: The lack of specialist physicians is a major concern in developing countries, especially in deprived cities. Objectives: This study aimed to identify the predictive variables of the turnover intention of physicians working in an undeveloped and deprived city in Iran. Methods: Participants were ۱۰۰ physicians working at North Khorasan University of Medical Sciences, Iran. The data were collected using a standard questionnaire of Turnover Intention, Interpersonal Conflict, Work-Family Conflict, Work Overload, and Organizational Support scales. We proposed a hybrid methodology to identify factors influencing turnover intention, which combines clustering and classification methods. RStudio ۱.۱, SPSS Clementine ۱۲, and SPSS ۲۲ programs were used for data analysis. After data clustering, we made a CART decision tree model for each cluster and used the variable importance feature of SPSS Clementine to discover the factors influencing turnover intention in each cluster. Results: We found two significant clusters of physicians’ turnover intention. In both clusters, interpersonal conflict (work ambiguity and work conflict) was the most important predictor of physician turnover intention, but physicians in the first cluster compared to the second had a higher turnover intention. In cluster ۱, work overload, organizational support, and work-family conflict were respectively the predictors of physician turnover intention and in cluster ۲, organizational support, work-family conflict, and final work overload were respectively the predictors of physician turnover intention. Conclusion: Cultural differences and the resulting interpersonal conflicts are the most important predictors of physician turnover intention in deprived areas. Turnover intention predictions of physicians with a longer work experience are different from that of others, and human resource managers must implement appropriate strategies to keep physicians in the deprived areas.

Keywords:

turnover intention , Work Ambiguity , Work Conflict , organizational support , work-family conflict , Work Overload