Retention of medical doctors in the public health sector : a case study of the Port Elizabeth Hospital complex

The Port Elizabeth (PE) hospital complex is one of the public hospital groups in South Africa facing a critical shortage of medical practitioners, with reference to doctors in particular. In the quest of finding how to retain doctors in the hospital complex, the aims of this research were to survey doctors’ career intentions; to investigate factors that could be contributing to these career intentions so as to uncover some of the reasons why doctors are leaving the public sector; and to identify effective ways in which the government and hospitals might improve retention by pointing out areas that need improvement. The factors that influence doctors’ career intention included income, work conditions, risk of contracting infection, risk of injury at work, hours of work, work load, work related stress, paid leave days, resources, personal growth and development opportunities, ongoing training opportunities, advancement and promotion opportunities, relation with co-workers, relations with supervisor/superiors, and sense of meaning. Findings revealed that even though the tendency to leave’ group (43%) was smaller than the ‘tendency to stay’ (57%), the majority (85%) of those who intended to leave were younger doctors. Despite some significant differences in responses between the two groups, results revealed that both groups were dissatisfied with almost all conditions of work apart from relationships with supervisors and co-workers. To a large extent, both groups revealed that work conditions are better in the private hospitals than in their current hospitals. viii The fact that some doctors could stay in the public hospital sector despite intense dissatisfaction with conditions of work, and despite the perception that that there are better options in the private hospitals could be attributed to the fact that most of these doctors are older and are at their retirement stage . Adding to this is that most of these doctors, who indicated willingness to say, scored high in sense of meaning as a factor influencing their career intention. This research was based on the assumption that there was no retention strategy put in place to solve the problems facing PE hospital complex. However, during this research a strategy was being developed and implemented by the Eastern Cape Department of Health. Therefore, evaluation and recommendations of the strategy are provided in the conclusions of the study. These recommendations relate not only to the implementation of the strategy, but improving it to accommodate all problems currently facing the doctors and finding ways and means of making the strategy sustainable; creating private-public partnerships; focusing on creating a sense of meaning amongst the doctors (especially the younger ones) and focusing on retaining the risk group which was the younger doctor