The impact of the clinical department director’s leadership style on the turnover intention of clinical doctors: a systematic literature review

Background: Clinical leadership plays a crucial role in managing doctors, yet its impact on doctors’ turnover intentions remains underexplored. This review examines the relationship between clinical leadership and doctors’ turnover intentions while identifying other contributing factors. Methods: PRISMA was used for the 2020–2024 systematic reviews. The data were collected from Scopus, PubMed, and the Web of Science databases until 2024. The Boolean keyword search approach identified 1,658 articles through pre-screening. Finally, 23 papers were chosen. These studies were assessed for bias using the ROBIS tool, Joanna Briggs Institute (JBI) Checklist, Symonds & Tang’s Checklist, and Hinderks et al.’s Checklist. Results: No significant risk of bias was found in these 23 studies, as most were methodologically rigorous, used validated measures, and demonstrated appropriate study designs. This systematic review includes 23 studies examining the relationship between clinical leadership and doctors’ turnover intentions. The studies were conducted across multiple countries, including the UK, Norway, the USA, China, Australia, Poland, Portugal, Malaysia, Finland, Indonesia, Nigeria, and Germany. The study designs range from empirical studies (n=2), observational studies (n=5), systematic reviews (n=4), qualitative studies (n=4), quantitative studies (n=7), and meta-analyses (n=1). Sample sizes vary significantly, from 18 (qualitative study) to 15,243 (large-scale observational survey). It was found that ineffective leadership styles, poor communication, lack of engagement, and centralised decision-making significantly increase physicians’ intentions to leave. The study also identifies transformational, participatory, and supportive leadership styles as key drivers of physician job satisfaction and retention across China’s healthcare system. Transformational leadership consistently correlates with improved communication, autonomy, and reduced turnover intention. In contrast, authoritarian, passive, and centralized leadership styles are linked to low affective and normative commitment, increased burnout, and higher intention to leave. Apart from those factors, such as age, gender, tenure, health, psychological state, and working hours, are also major contributors to job dissatisfaction. Conclusions: This systematic review provided evidence that strengthening supportive leadership and organizational climate can inform targeted clinical practices and leadership policies aimed at improving physician retention and reducing turnover-related disruptions in care.

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