Aoife McDermott, PhD, is continuing her work in the US and will return in the new year to take up a post as Professor of Human Resource Management at Aston University.
Prior to her fellowship at University of California, Berkeley, Aoife was Professor of Human Resource Management at Cardiff University, where her work considered the role of people management in supporting service delivery and improvement in health and social care. Her recent research has focused on the employment relationships and retention of health care staff.
With Hector Rodriguez, Ph.D., M.P.H., (Kaiser Permanente Endowed Professor, Health Policy and Management; Director, Center for Healthcare Organizational and Innovation Research, UC Berkeley School of Public Health) as her mentor, Aoife focused on Strengthening Primary Care Through Clinical Staffing
A committed teacher, Aoife was founding program director of the M.Sc./Diploma in health care planning, commissioned by the Welsh Government and NHS Wales to provide a talent pipeline in this space. McDermott previously coordinated the multidisciplinary Cardiff Health Organization and Policy Studies (CHOPS) research group and is trustee of the Learned Society for Studies in Organizing Healthcare. She has organized the society’s biannual International Organizational Behavior in Healthcare Conference, and edited book and special issue collections produced from these meetings. Educated at Trinity College Dublin, McDermott was a Trinity Scholar, awarded a gold medal, and completed her Ph.D. as a Government of Ireland Research Scholar. She is a fellow of the Academy of Social Sciences.
Strengthening of primary health care is a Commonwealth Fund imperative and a shared policy priority in the U.S. and the U.K. Both countries face shortages in the supply of primary care clinicians despite attempts to enhance multidisciplinary teamworking, and face challenges in retaining those currently in post because of work-related pressures.
Aoife’s research was underpinned by a concern with primary care physicians’ employment relationships and experiences at work. It had three aims. First, to understand the factors that influence primary care clinicians’ assessments of the attractiveness of their roles. Second, to identify potential interventions to enhance experiences of work and support retention. Third, to identify stakeholders with capacity and influence to enact the identified interventions.
PCPs discussed the value they placed on relationships with their patients. These were perceived to support understanding, whole person care, and enhanced patient outcomes. Adequate consultation time enabled such relationships and care delivery. These factors were impacted by work design and payment systems.
At sector level, there was recognition that relative status and renumeration for primary care providers requires attention. At organisational level, there was evidence of a range interventions to support PCP wellbeing and retention. These included work life balance supports focused on working time and work tasks, use of data to identify individuals requiring support (e.g., notes completion), practice community and culture, and iterative efforts to remove pain points.
Interventions to support PCP retention should both respond to the demands they face and be protective of the distinctive aspects of work they value.
Fisher, R. and McDermott, A. M. 2023. The battle to retain GPs: why practice culture is critical. BMJ 380 (10.1136/bmj.p344)
McDermott, A. M., Sarkar, U. and Fisher, R. 2023. Measuring The Impact Of Interventions To Retain Health Care Staff. Health Affairs (10.1377/forefront.20230621.460867)