Push and pull factors in medical employees' turnover decisions: the effect of a careerist approach and organizational benefits on the decision to leave the job

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Abstract
This paper aims at understanding the relative impact of 'careerist' attitudes and organizational benefits on prospective turnover decisions. We argue that the push/pull trade-off between careerist attitudes and organizational benefits in relation to turnover is occupation-specific. This is assessed by combining the sociological hypothesis of occupational 'market viability' and the organizational focus on opportunities. Testing this assertion, we examined turnover decisions for four occupational groups from eight medical institutions located in seven geographic areas. Initial results showed occupational variations in the weight given to 'careerist' versus organizational benefits in turnover decisions. Results from two logistic regression models suggest that organizational benefits, in contrast to a 'careerist' orientation to work, restrain occupation-specific turnover behaviour, even when controlling for the effect of perceived opportunities. These results are interpreted in terms of the 'market viability' hypothesis which stresses occupational variations in opportunities. Economic fluctuations for peripheral employees possessing general, rather than firm-specific skills may improve, rather than limit employment alternatives and hence enhance rather than constrain turnover decisions.

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