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:: Volume 29, Issue 7 (Special Issue 2025) ::
Feyz Med Sci J 2025, 29(7): 797-802 Back to browse issues page
Challenges in the retention of clinical faculty physicians under the geographic full-time commitment: A policy brief
Ehsan Zarei , Lida Shams , Masoud Arianfar *
Department of Health Services Management, Faculty of Health and Safety, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran , arianfar@sbmu.ac.ir
Abstract:   (84 Views)
Clinical academic physicians play a pivotal role in ensuring the quality of medical education, delivering specialized clinical services, and advancing health equity. However, recent field evidence indicates that the current implementation of the “Geographic Full-Time” (GFT) scheme has led to rising dissatisfaction and increased turnover intentions, potentially undermining educational and clinical productivity and equitable access to specialized care. This policy brief identifies key determinants of retention, including the public–private income gap, deficiencies in the provider payment system and delays in performance-based payments, excessive workload and professional burnout, weak regulatory oversight of dual practice, and insufficient place-based incentives. In an inflationary context characterized by declining real income, restrictive policies without adequate financial compensation and effective governance mechanisms face a heightened risk of reduced organizational commitment and workforce attrition. Based on comparative policy analysis, three strategic options are proposed: (1) strengthening the Geographic Full-Time model through meaningful and sustainable financial and non-financial incentives; (2) permitting regulated dual practice with mandatory disclosure, clearly defined time caps, and institutional revenue-sharing arrangements; and (3) implementing targeted, specialty- and region-based contractual models to address critical workforce shortages. The comparative assessment suggests that each option entails trade-offs in terms of effectiveness, fiscal sustainability, equity, and implementation feasibility, and reliance on any single approach carries substantial risk. Accordingly, the preferred policy recommendation is the adoption of a comprehensive, integrated policy package.
Keywords: Geographic Full-Time Commitment, Retention of Clinical Faculty Physicians, Health Workforce Policy, Policy Brief
Full-Text [PDF 374 kb]   (33 Downloads)    
Type of Study: Policy Brief | Subject: medicine, paraclinic
Received: 2025/12/22 | Revised: 2026/04/8 | Accepted: 2026/02/18 | Published: 2026/03/15
References
1. Bayat M, Salehi Zalani G, Harirchi I, Majdzadeh R, Nedjat S, Asghari F, et al. Extent and nature of dual practice engagement among Iranian medical specialists. Hum Resour Health. 2018; 16(1):61. doi:10.1186/s12960-018-0326-4 PMid:30453977 PMCid:PMC6245857
2. Moghri J, Arabloo J, Rahatlou MB, Khani S, Moghri A. Physicians' dual practice in Iran: A scoping review. PLOS ONE. 2022; 17(11): e0277896. doi:10.1371/journal.pone.0277896 PMid:36399479 PMCid:PMC9674143
3. Hoogland R, Hoogland L, Handayani K, Sijstermans E, Broerse JEW, et al. Global problem of physician dual practices: A literature review. Iran J Public Health. 2022; 51(7):1444-1460. doi:10.18502/ijph.v51i7.10079 PMid:36248302 PMCid:PMC9529729
4. García-Prado A, González P. Policy and regulatory responses to dual practice in the health sector. Health Policy. 2007;84(2-3):142-152. doi:10.1016/j.healthpol.2007.03.006 PMid:17449134
5. Abera GG, Alemayehu YK, Herrin J. Public-on-private dual practice among physicians in Ethiopia. BMC Health Serv Res. 2017;17:713. doi:10.1186/s12913-017-2701-6 PMid:29126453 PMCid:PMC5681802
6. nternational Monetary Fund. World Economic Outlook Database. 2025.
7. Dargahi H, Zalvand R. Analysis of the geographic full-time plan using SWOT model. Hospital. 2019; 18(1):9-20.
8. Akbari-Sari A, Babashahi S, Ghanati E, Rashidian A, Arab M. Challenges of physicians' full-time practice plan. J Kerman Univ Med Sci. 2012;79(1).
9. Yousefi M, Taziki S. Challenges of full-time clinical faculty under health transformation plan. Health Policy Q. 2018; 9(3):353-366.
10. Doshmangir L, Rashidian A, Kouhi F, Gordeev VS. Setting health care services tariffs in Iran. Int J Equity Health. 2020;19:112. doi:10.1186/s12939-020-01224-1 PMid:32631344 PMCid:PMC7336437
11. Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, et al. Prevalence of burnout among physicians. JAMA. 2018;320(11):1131-1150. doi:10.1001/jama.2018.12777 PMid:30326495 PMCid:PMC6233645
12. Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, et al. Career fit and burnout among academic faculty. Arch Intern Med. 2009; 169(10): 990-995. doi:10.1001/archinternmed.2009.70 PMid:19468093 PMCid:PMC11108200
13. Kamali M, Azizi M, Moosazadeh M, Ghasemian R, Reskati MH, et al. Occupational burnout in Iranian health care workers. BMC Psychiatry. 2022; 22:365. doi:10.1186/s12888-022-04014-x PMid:35643438 PMCid:PMC9143709
14. Ferrinho P, Van Lerberghe W, Fronteira I, Hipólito F, Biscaia A. Dual practice in the health sector. Hum Resour Health. 2004;2:1. doi:10.1186/1478-4491-2-14 PMid:15509305 PMCid:PMC529467
15. Jan S, Bian Y, Jumpa M, Meng Q, Nyazema N, et al. Dual job holding in resource-constrained settings. Bull World Health Organ. 2005; 83:771-776. PMID: 16283054 PMCID: PMC2626421
16. Alaref J, Awwad J, Araujo E, Soleman N, AlKhaldi M. Regulating dual practice in Palestine. Health Syst Reform. 2017;3(1):42-55. doi:10.1080/23288604.2016.1272980 PMid:31514710
17. Fadzil MM, Wan Puteh SE, Aizuddin AN, Ahmed Z. Specialists' dual practice in Malaysia. Healthcare. 2022;10(10):2097. doi:10.3390/healthcare10102097 PMid:36292543 PMCid:PMC9601889
18. New South Wales Ministry of Health. Staff Specialists (State) Award - Rights of Private Practice Scheme. 2015.
19. New South Wales Ministry of Health. Staff specialist salary increases from 1 October 2023 (IB2023_037). 2023.
20. Department of Health (England). A code of conduct for private practice. 2004.
21. House of Commons Committee of Public Accounts. NHS pay modernisation. 2007.
22. World Health Organization. Governance of dual practice in the public and private health sectors. 2024.
23. World Health Organization. Increasing access to health workers in remote and rural areas. 2010.
24. Bärnighausen T, Bloom DE. Financial incentives for return of service. BMC Health Serv Res. 2009; 9: 86. doi:10.1186/1472-6963-9-86 PMid:19480656 PMCid:PMC2702285
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Zarei E, Shams L, Arianfar M. Challenges in the retention of clinical faculty physicians under the geographic full-time commitment: A policy brief. Feyz Med Sci J 2025; 29 (7) :797-802
URL: http://feyz.kaums.ac.ir/article-1-5476-en.html


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