Title:
Why risk professional fulfilment: a grounded theory of physician engagement in healthcare development.

Abstract:
The need for trans-professional collaboration when developing healthcare has been stressed by practitioners and researchers. Because physicians have considerable impact on this process, their willingness to become involved is central to this issue.
This study aims to gain a deeper understanding of how physicians view their engagement in healthcare development.
Using a grounded theory approach, the study developed a conceptual model based on empirical data from qualitative interviews with physicians working at a hospital (n = 25).
A continual striving for experiences of usefulness and progress, conceptualized as 'striving for professional fulfilment' (the core category), emerged as a central motivational drive for physician engagement in healthcare development. Such experiences were gained when achieving meaningful results, having impact, learning to see the greater context and fulfilling the perceived doctor role. Reinforcing organizational preconditions that facilitated physician engagement in healthcare development were workplace continuity, effective strategies and procedures, role clarity regarding participation in development and opportunities to gain knowledge about organization and development. Two opposite role-taking tendencies emerged: upholding a traditional doctor role with high autonomy in relation to organization and management, clinical work serving as the main source of fulfilment, or approaching a more complete 'employeeship' role in which organizational engagement also provides a sense of fulfilment.
Experiencing professional fulfilment from participation in healthcare development is crucial for sustainable physician engagement in such activities.