You never stop being a doctor: The stories of Russian immigrant physicians who converted to physiotherapy

This article is based on 28 in-depth interviews with Russian immigrant physicians (11 men and 17 women, age range 30-53) who decided not to seek Israeli medical license and converted to physiotherapy. This research was theoretically informed by the literature on physicians' professional commitment. It explored the case of conversion from a perceived higher to lower status health care occupation and the ensuing changes in former doctors' professional self-image, relations with the patients and colleagues, and adjustment to the new work role. Informants were recruited among the graduates of the retraining courses sponsored in the mid-1990s by the Israeli Ministry of Health in order to provide jobs for immigrant doctors and to fill in existing vacancies in physiotherapy. The stories of former MDs-novice physiotherapists indicate that most are well adjusted to their new role, maintain positive professional self-image, and are satisfied with the terms of their employment. At the same time, most informants admitted that their mode of thinking and relation to patients remained those of physicians rather than paramedics. Some informants gave medical advice to the patients (especially to their co-ethnics) when asked and discussed treatment options with physicians whenever the work context allowed. Ostensibly good readjustment of this group may reflect the interplay of their actual success in the new role, reluctance to disclose problems in the interview, and self-selection of this group (i.e. doctors who were ready to trade their higher status for pragmatic work benefits). We conclude that complete occupational makeover of immigrant physicians is hardly possible; their professional socialization leaves deep imprint on the mindset and conduct, regardless of subsequent career change.