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This article aims to review some of the literature relating to the concept of effective engagement of doctors with health service redesign and delivery and discuss the relevance in light of recent developments from the Academy of Medical Royal Colleges.

This article is a literature overview and personal reflection. It contains elements of personal reflection on the recent historical policy changes that have the potential to lead to frontline changes in the development of managerial training for doctors and how this could benefit healthcare systems

For services to be effective doctors need to be engaged in their design. Historically the engagement of doctors in this process has been haphazard and often taken on by doctors who have been provided with little management training. This has led to internal and external conflict and possibly been a contributing factor to lack of clinical engagement. The recent suggestions by the Academy of Medical Royal Colleges and NHS Institute for Innovation and Improvement around mandatory management training for doctors throughout all stages of their training as doctors has the potential to improve effective clinical engagement of doctors in service redesign and delivery and therefore their potential for success.

This paper has been written by a consultant psychiatrist who is involved with frontline delivery of services, medical management and training of doctors and medical students.

Notes that medical participation in organization‐wide quality programmes and leadership of quality is commonly viewed as the key to a successful programme. Reviews and reports research into doctors’ involvement in such programmes as distinct from doctors’ involvement in medical quality activities. Reveals the lack of systematic evidence on the subject, suggests areas for future research, and summarizes what is known. Gives recommendations based on reported research and experience for quality training for doctors and how medical managers might engage their colleagues and other professions in quality programmes.

The purpose of this paper is to review the current literature and summarises the benefits and limitations of having doctors in health management roles in today’s complex health environment.

This paper reviews the current literature on this topic.

Hospitals have evolved from being professional bureaucracies to being managed professional business with clinical directorates in place that are medically led.

Limitations include the difficulty doctors have balancing clinical duties and management, restricted profession-specific view and the lack of management competencies and/or training.

The benefits of having doctors in health management include bottom-up leadership, specialised knowledge of the profession, expert knowledge of clinical care, greater political influence, effective change champions to have on-side, frontline leadership and management, improved communication between doctors and senior management, advocacy for patient safety and quality, greater credibility with public and peers and the perception that doctors have more power and influence compared to other health professionals can be leveraged.

Overall, there are more benefits than there are limitations to having doctors in health management but there is a need for more management training for doctors.

Based upon empirical research conducted in 1993, attempts to illustrate the implications of efforts to bring doctors into management. It addresses in particular the role of key appointments such as the medical director and clinical directors and the perceptions of these roles. Doctors continue to demonstrate themselves to be reluctant managers and this continues to pose problems for the aspirations contained in Working for Patients. Crucial questions must be asked about whether management represents a productive use of doctors′ time and whether the NHS can afford premium rates for largely inexperienced managers. Identifies changes that have taken place to date and indicates that doctors are, for the most part, still lukewarm about a career in medical management.

To explore theoretically the reasons for the modest uptake of clinical governance practices by taking the literature on the origin of tensions between doctors and managers as the starting‐point.

The approaches of doctors and managers to the division and coordination of medical work are analysed theoretically from a twofold perspective that combines insights from sociologists' theories on “professionalism” and administrative scientists' theories on “management science”.

The combined perspective theoretically explains the problems between doctors and managers that frustrate the uptake of clinical governance practices. By inference from this theoretical analysis, a twofold agenda for a constructive dialogue is proposed. Doctors and managers must develop a shared vision of the division and coordination of medical work as well as discussing the values, norms and goals underlying patient care. It is questionable, however, whether this agenda is currently adequately addressed.

This paper provides a theoretical underpinning for the dialogue between doctors and managers. It may be enlightening for all doctors and managers working in the field.

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

The institutional conditions of primary care provision remain understudied in low- and middle-income countries. This study analyzes how primary care doctors cope with medical uncertainty in municipal clinics in urban India. As street-level bureaucrats, the municipal doctors occupy two roles simultaneously: medical professional and state agent. They operate under conditions that characterize health systems in low-resource contexts globally: inadequate state investment, weak regulation and low societal trust. The study investigates how, in these conditions, the doctors respond to clinical risk, specifically related to noncommunicable diseases (NCDs).

The analysis draws on year-long ethnographic fieldwork in Pune (2013–14), a city of three million, including 30 semi-structured interviews with municipal doctors.

Interpreting their municipal mandate to exclude NCDs and reasoning their medical expertise as insufficient to treat NCDs, the doctors routinely referred NCD cases. They expressed concerns about violence from patients, negative media attention and unsupportive municipal authorities should anything go wrong clinically.

The study contextualizes street-level service-delivery in weak institutional conditions. Whereas street-level workers may commonly standardize practices to reduce workload, here the doctors routinized NCD care to avoid the sociopolitical consequences of clinical uncertainty. Modalities of the welfare state and medical care in India – manifest in weak municipal capacity and healthcare regulation – appear to compel restraint in service-delivery. The analysis highlights how norms and social relations may shape primary care provision and quality.

This research aims to investigate the symbiotic relationship between work and family life among doctors in India, with a focus on work–family enrichment (WFE) as a positive interplay. The study seeks to examine the impact of two aspects of WFE, namely, work-to-family enrichment (WTFE) and family-to-work enrichment (FTWE) on job satisfaction (JS) and life satisfaction (LS), while exploring the mediating role of self-efficacy (SE).

The research employs a comprehensive survey to gather data from Indian doctors. The survey includes measures of WTFE, FTWE, JS, LS and SE. Structural equation modeling (SEM) was employed to examine the proposed connections among the research constructs, using IBM AMOS v.23.

The findings reveal that WTFE significantly impacts both JS and LS. However, FTWE does not show a direct influence on JS, though it does positively impact LS. SE plays a noteworthy role, having a strong direct influence on both job and life satisfaction. In terms of indirect influence, WTFE impacts job and life satisfaction through the mechanism of SE. Nevertheless, no significant indirect effect was found between FTWE and both types of satisfaction through SE.

This research presents several original contributions to the study of work–life balance among healthcare professionals. Firstly, its unique geographic focus on North India distinguishes it from existing literature, offering fresh insights into the experiences of doctors in this region. Moreover, the study's multifaceted examination of WFE, SE, JS, and LS introduces a comprehensive perspective seldom seen in current research.

Doctors are more likely to suffer from mental illness in comparison to the wider population. This is particularly true for junior doctors, who are at increased risk in comparison to their senior colleagues. This study aims to identify whether junior doctors in North London are comfortable discussing mental health problems with their peers and supervisors and to compare how comfortable they are discussing mental and physical health problems.

An anonymous online questionnaire was designed with demographic data, multiple-choice questions and free-text boxes. This was distributed via email to core psychiatry trainees and foundation doctors in North London. Drug- and alcohol-related disorders were excluded from our definition of mental illness in this survey, as these are reportable to the General Medical Council.

A total of 51 junior doctors responded to the survey. The respondents were significantly more likely to discuss mental health problems with their peers in comparison to their supervisors. They were also less likely to discuss mental health problems in comparison to physical health problems with their peers, supervisors or general practitioner. Qualitative analysis of the free-text comments elucidated several themes including the stigmatisation of mental health.

To the best of the authors’ knowledge, there has been no prior research in the UK comparing the attitudes of junior doctors towards physical and mental ill-health. The questionnaire highlights the continued stigma towards mental health within the medical profession. The difference in attitudes towards physical and mental ill-health has important implications for the training and well-being of junior doctors.

Short-form health science videos have become an important medium for disseminating health knowledge and improving public health literacy. However, the factors that determine viewer engagement are not well understood. This study aims to address this research gap by investigating the association between doctor image features and viewer engagement behavior, building on the personal branding theory and information signaling theory.

A sample of 1245 health science short-form videos was collected, and key video features related to doctor images were extracted through manual labeling. Multi-variable regression analysis and SPSS process model were employed to test the hypotheses.

The results show that doctor image features are significantly associated with viewer engagement behavior. Videos featuring doctors in medical uniforms receive more viewer likes, comments and shares. Highlighting the doctor's title can increase viewer collections. Videos shot in a home, white wall, or study room setting receive more like, comments and sharing. The doctor's appearance demonstrates a positive nonlinear relationship with viewer likes and comments. Young doctors with title information tend to attract more video collections than older doctors with title information. The positive effect of the doctor's appearance and showing title information, become more significant among male doctors.

This research provides novel insights into the factors that determine viewer engagement behavior in short-form health science videos. Specific doctor image features can enhance viewer engagement by signaling doctor professionalism. The results also suggest that there may be age and gender biases in viewers' perceptions.