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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 post-COVID-19 era is characterised in the professional field by a deterioration in the psychological health of employees and by “The Great Resignation”. These phenomena require managers to rethink both organisational and HR strategies to protect their workers’ health, to retain them in their job and, in fine, to ensure the sustainability of the organisation. However, studies have demonstrated that high performance work systems (HPWS), which are currently the dominant approach in human resource management, are related to an intensification of work and consequently a deterioration of employees’ health (conflicting outcomes perspective). At the same time, workers’ well-being has been shown to be associated with numerous organisational outcomes, such as individual performance. However, relatively few articles have investigated win–win organisational practices or programmes that promote the well-being and consequently performance of workers. These include virtuous organisational practices (VOPs), which specifically aim to enhance employees’ well-being, considered not as a means to an end, but as an end in itself (mutual gains perspective). This paper aims to develop the general hypothesis that VOPs could increase employees’ performance by protecting their health and thus offer an alternative to HPWS.

We review relevant current research on psychological well-being and work performance and present innovative systems of organisational practices such as VOPs that create psychologically healthy workplaces and enhance workers’ optimal functioning (well-being and performance).

Based on theoretical arguments and empirical studies, we hypothesise that alternative practices such as VOPs can increase employees’ performance while protecting their health and encouraging them to stay in the organisation.

After this review, we discuss future avenues for research to encourage the scientific community to test this hypothesis.

Finally, we make a number of specific recommendations about how to (1) appraise, design and implement VOPs, (2) enhance organisational communication and managerial adherence to VOPs, and (3) train managers in R.I.G.H.T leadership behaviours.

Presentation of an original approach in this research field: the VOPs.