期刊论文详细信息
BMC Medical Education
University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians
Ludwig Kuntz1  Christiane Degen1 
[1] Department of Business Administration and Health Care Management, University of Cologne, Albertus-Magnus-Platz, Cologne 50931, Germany
关键词: University hospitals;    Promotion;    Hospital physicians;    Career success;   
Others  :  866723
DOI  :  10.1186/1472-6920-14-85
 received in 2012-11-13, accepted in 2014-04-10,  发布年份 2014
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【 摘 要 】

Background

German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians.

Methods

Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions.

Results

Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1–2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3–4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital.

Conclusion

Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.

【 授权许可】

   
2014 Degen and Kuntz; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Jacobs K, Marcon G, Witt D: Cost and performance information for doctors: an international comparison. Manage Account Res 2004, 15(3):337-354.
  • [2]Schulz R, Harrison S: Physician autonomy in the Federal Republic of Germany, great Britain and the United States. Int J Health Plan M 1986, 1(5):335-355.
  • [3]Dent M, Howorth C, Mueller F, Preuschoft C: Archetype transition in the German health service? the attempted modernization of hospitals in a North German State. Public Admin 2004, 82(3):727-742.
  • [4]Vera A, Hucke D: Managerial orientation and career success of physicians in hospitals. J Health Org M 2009, 23(1):70-84.
  • [5]Leicht KT, Fennell ML: The changing organizational context of professional work. Annu Rev Sociol 1997, 23:215-231.
  • [6]Wachter RM: An introduction to the hospitalist model. Ann Intern Med 1999, 130(4 Part 2):338-342.
  • [7]Løvseth LT, Fridner A, Jónsdóttir LS, Marini M, Linaker OM: Associations between confidentiality requirements, support seeking and burnout among University Hospital physicians in Norway, Sweden, Iceland and Italy (the HOUPE study). Stress Health 2013, 29(5):432-437.
  • [8]Taylor C, Graham J, Potts HWW, Richards MA, Ramirez AJ: Changes in mental health of UK hospital consultants since the mid-1990s. Lancet 2005, 366(9487):742-744.
  • [9]Freese H-J, Rudolphi M: Berufseinstieg im Krankenhaus. In Approbation - und danach? Ein Leitfaden zum Berufseinstieg für Ärztinnen und Ärzte. Edited by Henke R, Botzlar A, Benemann M. Heidelberg: medhochzwei; 2011:19-33.
  • [10]Buddeberg-Fischer B, Stamm M, Buddeberg C, Klaghofer R: Career-success scale - a new instrument to assess young physicians’ academic career steps. BMC Health Serv Res 2008, 8:120. BioMed Central Full Text
  • [11]Boor K, Scheele F, Brölmann HAM, Schoot JT, van der Velden LFJ, van der Dorr PJ: University hospital or district hospital? the views of clinical clerks. Dutch J Med Educ 2005, 24:87-94.
  • [12]Bruijn M, Busari JO, Wolf BHM: Quality of clinical supervision as perceived by specialist registrars in a university and district teaching hospital. Med Educ 2006, 40(10):1002-1008.
  • [13]Rotem A, Godwin P, Du J: Learning in hospital settings. Teach Learn Med 1995, 7(4):211-217.
  • [14]Leonhard EM: Abgrenzung von klinischer Forschung, Lehre und Krankenversorgung: Auswirkungen auf Finanzierung und organisation von Universitätsklinika. Berlin: Berliner Wissenschafts-Verlag; 2005.
  • [15]Briscoe F: Temporal flexibility and careers: the role of large-scale organizations for physicians. ILR Review 2006, 60(1):88-104.
  • [16]von Bülow A, Schriek G: Vom Oberarzt zum Chefarzt: Ein dorniger Weg. Dtsch Arztebl 2005, 102(8):A-536. B-456 / C-424
  • [17]Frank E, McMurray JE, Linzer M, Elon L: Career satisfaction of US women physicians: results from the women physicians’ health study. Arch Intern Med 1999, 159(13):1417-1426.
  • [18]Landon Be RJBD: Changes in career satisfaction among primary care and specialist physicians, 1997–2001. JAMA 2003, 289(4):442-449.
  • [19]Leigh J, Kravitz RL, Schembri M, Samuels SJ, Mobley S: Physician career satisfaction across specialties. Arch Intern Med 2002, 162(14):1577-1584.
  • [20]Cydulka RK, Korte R: Career satisfaction in emergency medicine: the ABEM longitudinal study of emergency physicians. Ann Emerg Med 2008, 51(6):714-722. e711
  • [21]Hamori M, Kakarika M: External labor market strategy and career success: CEO careers in Europe and the United States. Hum Resour Manage 2009, 48(3):355-378.
  • [22]Ng TWH, Eby LT, Sorensen KL, Feldman DC: Predictors of objective and subjective career success: a meta-analysis. Pers Psychol 2005, 58(2):367-408.
  • [23]Heslin PA: Conceptualizing and evaluating career success. J Organ Behav 2005, 26(2):113-136.
  • [24]Pachulicz S, Schmitt N, Kuljanin G: A model of career success: a longitudinal study of emergency physicians. J Vocat Behav 2008, 73(2):242-253.
  • [25]Singer JD, Willett JB: Applied longitudinal data analysis: modeling change and event occurrence. New York: Oxford University Press; 2003.
  • [26]Long JS, Allison PD, McGinnis R: Rank advancement in academic careers: sex differences and the effect of productivity. Am Sociol Rev 1993, 58(5):703-722.
  • [27]Arthur MB, Khapova SN, Wilderom CPM: Career success in a boundaryless career world. J Organ Behav 2005, 26(2):177-202.
  • [28]Degen C, Kuntz L: Rank advancement in medical careers: the role of inter-organizational mobility and organizational size. Working Papers on Health Care Management. University of Cologne: Cologne; 2013:1-28.
  • [29]Buddeberg-Fischer B, Klaghofer R, Abel T, Buddeberg C: Junior physicians’ workplace experiences in clinical fileds in German-speaking Switzerland. Swiss Med Wkly 2005, 135:19-26.
  • [30]Buddeberg-Fischer B, Klaghofer R, Zivanovic I, Vetsch E, Buddeberg C: Institutional conditions and individual experiences in the career-entry period of Swiss medical residents - a qualitative study. Swiss Med Wkly 2006, 136:26-32.
  • [31]Brüderl J, Preisendörfer P, Ziegler R: Upward mobility in organizations: the effects of hierarchy and opportunity structure. Eur Sociol Rev 1993, 9(2):173-188.
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