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Background Burnout among physicians is growing at an exponential rate and many are leaving the profession. Nevertheless, the specific antecedents and intermediary stages involved in predicting their professional turnover intentions are not fully clear. Purpose We apply the Job Demands-Resources model and investigate an innovative model which predicts physician burnout and its ultimate consequences on professional turnover intentions. Methodology/approach Structural equation modeling was used on cross-sectional survey data from a sample of 407 Canadian physicians. Results/conclusions Job demands (work stress, work overload, and work-family conflict) and job resources (patient recognition and meaning at work) influence intention to leave the profession through a two stage health-impairment and motivational process related to health problems and professional commitment, respectively. Practical implications This study identifies key job resources and job demands which predict physician burnout and professional turnover intentions thereby pinpointing which levers managers can use improve their health and retain them in the profession.

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Purpose The purpose of this paper is to study the factors influencing doctors' involvement in Lean change initiatives in public healthcare organizations in Canada. Design/methodology/approach An inductive research was conducted over a three-year span studying Lean implementation across three healthcare organizations in Canada. Various interviews were conducted with healthcare actors. Through analytical induction, analysis of the data allowed for multiple factors to be triangulated from which a conceptual model was developed. Findings Fifty-four interviews with 18 Lean healthcare actors allowed for the identification of ten factors possibly influencing the commitment of doctors towards Lean change. These factors are categorized into pre-change antecedents and change antecedents. Also, the level of transformational leadership demonstrated by a project manager was shown to potentially moderate the effect of medical behavioral support for change on change outcomes. These findings allowed us to develop a conceptual model of medical commitment and its impact of Lean change outcomes. Originality/value The paper investigates the role doctors play in Lean implementation, currently an important issue discussed among healthcare actors and researchers. Yet, very little academic research has been published on this subject.