Von der Deprofessionalisierung zur Reprofessionalisierung im Krankenhaus?

Wilkesmann, Maximiliane; Apitzsch, Birgit; Ruiner, Caroline

doi:10.5771/0038-6073-2015-3-327

Cited by 14 publications

(2 citation statements)

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“…In addition to financial gain, the execution of professional autonomy forms the main driver for German locum physicians to opt out of the system of permanent employment [ 27 ]. Locums perceive that they enjoy a high degree of freedom in their medical decision-making which takes place widely outside hospital hierarchies and organisational restraints.…”

Section: Discussionmentioning

confidence: 99%

Locum physicians’ professional ethos: a qualitative interview study from Germany

Salloch

Apitzsch²,

Wilkesmann

et al. 2018

BMC Health Serv Res

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BackgroundIn contrast to other countries, the appearance of locum physicians as independent contractors constitutes a rather new phenomenon in the German health care system and emerged out of a growing economization and shortage of medical staff in the hospital sector. Locums are a special type of self-employed professionals who are only temporally embedded in organisational contexts of hospitals, and this might have consequences for their professional practice. Therefore, questions arise regarding how locums perceive their ethical duties as medical professionals.MethodsIn this first qualitative study on German locum physicians, the locums’ own perspective is complemented by the viewpoint of permanently employed physician colleagues. Eighteen semi-structured interviews were conducted in 2014 to explore the professional practice of locum physicians from both groups’ perspectives with respect to doctor-patient-relationship, cooperation with colleagues and physicians’ role in society. The data were analysed using qualitative content analysis, including a deductive application and an inductive development of codes. The results were related to key tenets of medical professionalism with respect to the question: how far do locums fulfil their ethical duties towards patients, colleagues and the society?ResultsThe study indicates that although ethical requirements are met broadly, difficulties remain with respect to close doctor–patient contact and the sustainability of hiring locums as a remedy in times of staff shortage.ConclusionsFurther qualitative and quantitative research on locum physicians’ professional practice, including patient perspectives and economic health care system analyses, is needed to better understand the ethical impact of hiring independent contractors in the hospital sector.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3118-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Locum physicians’ professional ethos: a qualitative interview study from Germany

Salloch

Apitzsch²,

Wilkesmann

et al. 2018

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…Als konkrete Gefährdungen der professionellen Autonomie werden Ökonomisierungstendenzen im Versorgungsbereich verbunden mit einem sich ausweitendem Anpassungsdruck, Zuteilungsvorgaben innerhalb der Ärzt*innen-Patient*innen-Beziehung sowie zunehmende Verschiebungen von Expert*innen- und Laienwissen zwischen Patient*innen und Ärzt*innen gesehen 20 29 35 . Trotz dieser Wandlungen gilt die ärztliche Tätigkeit weitgehend noch als „starke“ Profession, stellenweise werden ihr bereits Reprofessionalisierungstendenzen zugeschrieben 2 38 .…”

Section: Professionalisierungsprozesse Von Berufsgruppen Im Gesundhei...unclassified