Threats or violence from patients was associated with turnover intention among foreign-born GPs – a comparison of four workplace factors associated with attitudes of wanting to quit one’s job as a GP

Abstract

ObjectiveGeneral practitioners (GPs) are crucial in medical healthcare, but there is currently a shortage of GPs in Sweden and elsewhere. Recruitment of GPs from abroad is essential, but foreign-born physicians face difficulties at work that may be related to turnover intention, i.e. wanting to quit one’s job. The study aims to explore the reasons to why foreign-born GPs may intend to quit their job.DesignSurvey data were used to compare four work-related factors that can be associated with turnover intentions; patient-related stress, threats or violence from patients, control of work pace, and empowering leadership, among native-born and foreign-born GPs. These work-related factors were subsequently examined in relation to turnover intention among the foreign-born GPs by means of linear hierarchical regression analyses. The questionnaire consisted of items from the QPS Nordic and items constructed by the authors.SettingA primary care setting in a central area of Sweden.SubjectsNative-born (n = 208) and foreign-born GPs (n = 73).ResultsTurnover intention was more common among foreign-born GPs (19.2% compared with 14.9%), as was the experience of threats or violence from patients (22% compared with 3% of the native-born GPs). Threats or violence was also associated with increased turnover intention. Control of work pace and an empowering leadership was associated with reduced turnover intention.Practice implicationsThe organisations need to recognise that foreign-born GPs may face increased rates of threats and/or violence from patients, which may ultimately cause job turnover and be harmful to the exposed individual.

Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis

“…[5][6][7][8][9] In addition, WPV has a negative impact on the retention of healthcare workers and the quality of medical care. [10][11][12] Healthcare workers are the main providers of healthcare services and the foundation of any healthcare system. The efficiency, effectiveness and quality of a nation's healthcare system are directly associated with the quality and size of its healthcare workforce.…”

Psychosocial work environment and cross‐cultural competence among native and foreign‐born registered nurses

“…For example, a previous study showed that foreign‐born health care professionals more frequently experience a lack of social support at work and work‐related distress than native nurses (Aalto, Heponiemi, Keskimaki, et al, ). Moreover, it has been shown that the risk of violence from patients and colleagues is higher among migrant health care employees (Crutcher, Szafran, Wolochuk, Chatur, & Hansen, ; Eneroth, Gustafsson Senden, Schenck Gustafsson, Wall, & Fridner, ). Health care professionals of foreign origin have also been reported to experience social isolation in the workplace (Chen et al, ) and to be at an increased risk of discrimination (Schilgen, Nienhaus, Handtke, Schulz, & Mosko, ).…”

Foreign-born physicians’ perceptions of discrimination and stress in Finland: a cross-sectional questionnaire study

“…Foreign-born physicians may face more insensitivity, discrimination and isolation in their workplace [ 7 , 8 ]. For example, foreign-born physicians had higher levels of threats or violence from patients compared to native physicians in Sweden [ 9 ] and foreign-born physicians have been found to face harassment from their colleagues [ 10 ]. Foreign-born physicians working in Germany have reported discrimination, difficulties in interpersonal interactions and a lack of setting-specific (language, cultural, clinical and system) knowledge [ 11 ].…”

“…However, there might also be factors that could attenuate these risks. For example, control over one’s job has been suggested to be especially important for foreign-born physicians [ 9 ]. Job control has been associated with lower turnover intention among foreign-born physicians [ 9 ] and it has been found to ease the potential challenges coming from working in culturally diverse teams [ 15 ].…”

“…For example, control over one’s job has been suggested to be especially important for foreign-born physicians [ 9 ]. Job control has been associated with lower turnover intention among foreign-born physicians [ 9 ] and it has been found to ease the potential challenges coming from working in culturally diverse teams [ 15 ]. Another concept that has been found important in culturally diverse working environments is team climate [ 15 ].…”