Abstract
BACKGROUND: Leadership and leaders have important roles today, possibly even more so in the future, since major organizational changes will occur throughout the health care sector. Tomorrow's leaders will need to be competent and motivated. It is important to clarify the factors why some individuals stay and some quit leadership positions. We investigated factors associating with dentist leaders' likelihood to stay in or leave a leadership position. METHODS: Data were gathered while or after participants attended "the Special Competence in dental administration for leading dentists" education, utilizing the method of empathy-based stories. Participants wrote short essays on the basis of two contrasting frame stories, i.e. an imagined situation where either they left (Leavers, Group 1) or stayed in (Stayers, Group 2) a leadership position. Content analysis was used inductively to describe intent to stay or to leave factors and categorized according to the theory of "Career Anchors". RESULTS: The factors were not only specific to groups, since several common factors were also found such as satisfaction with leadership position even though the post was not initially the participant's voluntary decision and the inadequate time for leadership work. Factors in both groups formed three themes: personal, working community, and health care sector levels. Both groups expected conditions to improve in their organizations, even though there were major concerns about on-going changes. Concurrently the uncertainty and the instability in the health care sector and the status of oral health care worried both groups. Leaver-specific factors were loneliness of leadership position, lack of support and the appropriate salary combined with the excessive number of duties. Stayer-specific factors were enthusiasm for leadership supported by education and possibility of develop oral health care as part of health care. The General Managerial Competence anchor was the dominant career anchor, especially among the Leaders. CONCLUSIONS: Working as a dentist leader is both demanding and challenging. In order to succeed and be personally satisfied and fulfilled in these leadership positions, it is essential to recognize either supporting or enervating factors towards leadership positions and that appropriate education, support, and time for leadership are needed.