Understanding Turnover Intentions in Pakistan’s Healthcare Sector: A Qualitative Exploration of Supervisory Behavior, Stress, and Cultural Norms

Abstract

This qualitative study explores the underlying organizational and cultural drivers behind the turnover intentions of healthcare professionals in Pakistan. Through 28 in-depth interviews with doctors, nurses, and paramedical staff from both public and private hospitals, the research investigates how abusive supervision, job stress, organizational culture, and hierarchical norms contribute to dissatisfaction and the desire to migrate or resign. Using thematic analysis and NVivo 12 software, several patterns emerged, including the normalization of obedience, resistance to authoritarian decisions, and frustration over professional disrespect. The study finds that power distance—a deeply ingrained cultural dimension shapes how subordinates respond to stressful and unjust work conditions. Moreover, burnout, departmental politics, and lack of resources are cited as key reasons for migration, particularly among young professionals. The findings contribute to a culturally contextualized understanding of turnover and call for policy-level interventions that address structural and interpersonal dysfunctions in the healthcare system.

Keywords: Turnover intention, qualitative interviews, healthcare, Pakistan, power distance, job stress