Abstract

Implementing the “hierarchical diagnosis and treatment” system highlights the important role of general practitioners as “residents’ health gatekeepers.” Still, the low level of career growth always limits the realization of their service value. Inertial thinking uses a single factor to explain the complexity of career growth in previous studies; in fact, it isn’t easy to assess whether the factor is a sufficient and necessary condition for a high level of career growth. Herein, we have used a set theory perspective to analyze the mechanism of influencing high-level career growth by combining psychological and organizational factors. This research aims to analyze causal complexity relationship between these conditions and results is analyzed in detail. We choose fuzzy-set qualitative comparative analysis with a sample of 407 GPs to test 5 antecedent conditional variables that can affect their career growth. The variables include professional identity, self-efficacy, achievement motivation, training mechanism, and incentive mechanism. To ensure the universality and diversity of data, the samples were selected from community medical institutions in different regions of China. The results show that three pathways can affect the high career growth of GPs, and the optimal pathway A2 is the linkage matching of high incentive mechanism, high professional identity, high achievement motivation, and high self-efficacy. At the same time, we find that professional identity plays an alternative role in the three pathways. When professional identity is at a high level, as long as achievement motivation and self-efficacy are superior, or achievement motivation, self-efficacy, and achievement motivation are superior, a high level of career growth can be achieved. We broke the shackles of previous studies that only focused on the impact of single factors on the career growth of GPs. From the perspective of set theory, we use configurational thinking to construct Influential pathways of high career growth of GPs by integrating antecedents. The results can provide effective support for improving GPs’ service ability and realizing their service value to protect residents’ health.