A sustainable health workforce is essential for health care delivery. Yet, sustainability is challenged by extreme work conditions – intensified by the longevity of the COVID-19 pandemic – which negatively impact the working lives of health care workers. Improving our understanding of the working lives of health care workers is a research and health care management priority. Synthesising the work of the Hospital Doctor Retention and Motivation (HDRM) project in Ireland with international literature, this chapter demonstrates (i) understaffing, weak retention, and burnout are key challenges for medical workforces, and (ii) significant deterioration of hospital doctors’ working lives, shaped by work-life imbalance, presenteeism, and also understaffing. These issues represent self-driving ‘cycles of deterioration’ within the work forces and work lives of medicine – linked by the critical role of understaffing. Echoing Bodenheimer and Sinsky (2014), the chapter emphasises the importance of research which enhances our understanding of the occupational and organisational conditions shaping the ‘health’ of hospital doctors’ working lives.

12 August, 2024

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