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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 paper aims to understand how the spread of coronavirus disease 2019 (COVID-19) influenced public employees' perception of smart working and how this approach was used during the pandemic. The authors asked about smart working's positive and negative aspects and how these changed during the pandemic.

The authors explored the strengths and weaknesses of smart working before and after COVID-19. The authors interviewed 27 Italian public employees who had experienced smart working before the pandemic. The questions and discussion aimed to broadly explore the strengths and weaknesses of smart working and smart working's impact on working performance, work relationships and work–life balance (WLB).

Smart working had a widespread and positive impact on organizational flexibility. Smart working improved the response and resilience of Italian public organizations to the pandemic. However, some critical factors emerged, such as the right to disconnect and the impact on WLB.

The authors suggest that the pandemic exposed the need for public administrations to consolidate work flexibility practices, such as smart working, by paying more attention to the impact of these practices on the whole organization and human resources management (HRM) policies and practices.

This study makes an important contribution to the literature on the public sector by discussing the positive and negative aspects of smart working. The study also provides managerial and policy implications of the use of smart working in public administrations.