A systems psychodynamics approach to doctors' intentions to stay in public hospitals: The "desire for dialogue"

The problem: In many developed Western countries, physicians tend to quit healthcare institutions. Factors contributing to physician retention are numerous, but young physicians' intentions towards public hospitals still seem mysterious to senior physicians and administrators. The solution: We investigate physicians' desire for a meaningful "dialogue" with their institution as an overarching need determining their intent to stay. Our data was gathered during a cooperative action-research project in a French University Hospital. We hypothesise that the physician–administrator relationship is crucial because the dialogue they hold in the "outer world" prolongs the dialogue in which physicians unconsciously engage with their institution-in-the-mind. The stakeholders: This article informs hospital administrators and managing physicians who need to ensure younger physicians remain in public healthcare institutions. This article's original clinical viewpoint will be of interest to healthcare organisations and other public service institutions wondering how interprofessional relationships contribute to professionals' intent to stay.