gms | German Medical Science

GMS Journal for Medical Education

Gesellschaft für Medizinische Ausbildung (GMA)

ISSN 2366-5017

Family-friendliness in business as a key issue for the future

Research article medicine

Search Medline for

  • corresponding author Erich Stutzer - Statistisches Landesamt Baden-Württemberg, FaFo FamilienForschung Baden-Württemberg, Stuttgart Deutschland

GMS Z Med Ausbild 2012;29(2):Doc34

doi: 10.3205/zma000804, urn:nbn:de:0183-zma0008048

This is the English version of the article.
The German version can be found at:

Received: March 3, 2011
Revised: December 6, 2011
Accepted: January 13, 2012
Published: April 23, 2012

© 2012 Stutzer.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


These days family-friendliness is a key issue for the future of businesses. Investments in a family conscious personnel policy are considered as forward-looking decisions in companies. This happens against the background of a sustainable personnel policy in times of a decrease in the number of employable persons, an increasing shortage of skilled workers and an ageing workforce. Family-friendly working conditions are becoming a key factor in the competition for staff. When choosing an employer, family-friendliness has become a crucial topic. Employment participation and skills of women, especially of mothers, have greatly increased. To facilitate the realisation of their wish to return to paid employment, however, measures to reconcile work and family are required.

Family-conscious measures have been proven to lead to higher employee productivity. Job satisfaction and motivation of employees and accumulation of human capital increase, absenteeism declines, the return of investment rises. Fields of activity for family-friendly measures in companies range from working arrangements, parental leave and re-entry programmes and various child care offers to services for families. In connection with the demographic development the demand for a better reconciliation of work and elder care should in future become ever more important, just as the upkeep of the occupational skills and working capacity of an ageing workforce. Family-friendliness has to become an integral part of corporate culture.

Keywords: Family-conscious personnel policy, family-friendly company, reconciling work and family, demographic change, educational levels, skill shortages, feminisation of the medical profession, CoE Work and Family, cost-benefit analysis

Family-friendliness as vital strategic advantage

Family-friendliness is now debated as a key issue for the future in companies. Family-friendly policies are no longer soft factors but have become hard factors. Investing in family-friendly personnel policies is seen as a forward-looking business decision and more and more companies judge the issue as being of great importance. By now 72% of business managers and HR managers in German companies see family-friendly policies as being very important, with the trend still rising [5]. This is happening against the backdrop of sustainable human resources policies in times of a shrinking workforce, an increasing shortage of skilled workers and an ageing workforce. Qualified and motivated staff is an important resource in business. Family-friendly working conditions are key in the competition for staff [3].

Today, many companies struggle with the issue of securing qualified staff, in particular in the medical arena. The need for doctors will only increase due to the demographic development and the ageing of the population over the next few years. At the same time, the number of qualified staff is dropping. Even today, not all openings in hospitals can be filled. The competition for qualified staff will increase in future [1], [7]. Family-friendly policies will be key in this competition.

In addition, the proportion of male to female doctors is changing in medicine. Only 15 years ago merely 35% of doctors were women, today there are 42%. The proportion of female doctors is increasing steadily []. Among medical students, already 63% are women (see Figure 1 [Fig. 1]).

Amongst students in the academic year 2008/2009 in medicine, 63% were women, the percentage of women in dentistry was 66% and in veterinary medicine, 83%. Among graduates in human medicine and dentistry, 58% were female, with 85% of graduates in veterinary medicine women.

These trends are reinforced by doctors emigrating abroad or to sectors outside healthcare. One in ten medical graduates opt for a career outside of patient care. Reasons given include the pay, working conditions and the lack of a balance between work and family life and the lack of re-entry support. Only 4% of physicians think the balance is good, 13% as fairly good but the great majority considers it bad. 79% of medical students find it difficult or very difficult to combine children and a medical career [].

As the percentage of women in medicine increases, the issue of reconciling work and family will gain in importance. If hospitals do not enable young female (and) male doctors to balance a career with family, they will lose valuable, highly skilled workers [6].

Societal Changes

Family policy and family-friendly policies in companies have become so important because important social factors are changing. Apart from globalisation, two mega-trends are relevant to these developments:

The demographic shift with a drop in population and ageing of the population and the decrease of the potential workforce and ageing of the workforce.
The process of societal modernisation
    • With changing values and roles,
    • Changes in family structure with increasing pluralisation of life styles and trends towards greater individualisation,
    • The strong expansion of education, from which women in particular have benefited,
    • Increasing skills amongst women connected with a strong increase in the participation of women in the workplace, especially mothers.

Demographic Change

Demographic change in Baden-Württemberg is leading to a decline in population, whilst the population is ageing rapidly (see Figure 2 [Fig. 2]).

Today there are nearly 82 million people in Germany. According to the official population forecasts, this number will drop to about 65 million reduced by 2060 [11]. This decrease applies to Germany as a whole but also in all German states. The decline in the individual federal states, however, varies.

Much more problematic than the decline of the population is its ageing. The average age in Germany in 1950 was 35 years. Today it stands at 43 and will rise to over 50 in 2060. The proportion of young people is declining, with the proportion of elderly and very elderly people increasing rapidly.

The proportion of young people under the age of 20 was almost at 20% in 2010 and will be around 16% in 2060. The proportion of the middle age bracket between 20 and 60 will shrink from 55% to 44% in the same period. The number of older people will greatly increase. The proportion of people between 60 and 85 will increase from 24% to 32% and the proportion of very elderly will more than quadruple from today’s 2% to 9%. The elderly’s absolute number will increase from 1.9 million today to about 5.6 million people in 2060.

One consequence of these developments will be that people in the middle bracket, those of working age, will have to support more and more older people, increasing the “burden” on the middle age bracket. The so-called dependency ratio measures the ratio of people aged 65 and older against the middle age bracket (between 20 and 65). Today, for every 100 people in the middle bracket there are 65 people who are older than 60. In 2060, there will be 98.

These demographic trends of population decline and ageing apply to the entire population. The same trends can also be observed amongst the active population. The number of employed people decreases over the next few years, potentially worsening the problem of skills shortages. The forecaster Prognos expects that in Baden-Württemberg for example, there will be a skill shortage of some 280,000 in 2015 and some 500,000 by 2030. At the same time the proportion of older people will increase significantly [9]. Since 2003, for the first time there are more older than younger people in employment amongst German workers and this will not change in coming years.

These demographic trends essentially are a result of the low birth rate in Germany. The proportion of large families with three or more children has declined significantly, while the proportion of childless women has increased. In particular academics increasingly remain childless. This points to failures in the reconciliation of work and family, especially amongst academics.

Societal Modernisation

The societal changes of interest here derive from changes in values and role expectations, which continue to change, changes in family structure with increasing pluralisation of life styles and trends towards greater individualisation. But also in the strong expansion of education, from which women in particular have benefitted and the sharp rise in female labour force participation, especially mothers, a factor associated with increasing skill levels amongst women.

The expansion of education in Germany has meant that the education level has risen enormously and that the young generation has the highest levels of education (see Figure 3 [Fig. 3]).

Women in particular have benefited from the expansion of education. Amongst young people today, more than 40% have leaving certificates qualifying for tertiary education, while 40 years ago only 6% of women had achieved this. Women have now overtaken men in terms of educational qualification. This is evident, amongst other things, from the fact that in the mid-90s for the first time more girls acquired A-levels than boys. Since then, this has been the case every year.

At the same time, the participation of women has steadily risen. This increase is solely due to mothers. While previously mothers often dropped out of the labour market with the birth of a child, more and more parents today try to juggle both areas of life, work and family, at the same time. Two thirds of mothers in Baden-Württemberg are gainfully employed (see Figure 4 [Fig. 4]).

Labour force participation by mothers increases with the age of the youngest child. Almost half of all mothers with infants under three years are economically active. If the youngest children are older, economic activity increases continuously. It should be noted though that three-quarters of working mothers are employed part-time.


On the one hand, this results in a constellation where there is a shortage of skilled workers with an ageing workforce and at the same time with a potential of workers consisting of very well-educated women who wish to be gainfully employed. But for them to achieve such career aspirations measures are required which allow them to reconcile work and family. If one were to succeed in providing adequate jobs to well-qualified women, one would create a win-win situation benefitting both companies and employees. This especially concerns the medical profession in the light of the increasing proportion of female doctors [6].

Family-friendliness in Business

Family-friendly Measures

Family-friendliness has become an important factor when choosing an employer. Scientific surveys show that 92% of workers (aged 25 to 39) with children consider the question of compatibility of family and career as more important or as important as the question of the salary when choosing a new employer. 78% of these people would be willing to switch to an employer who offers a better balance between the two areas of life [] (see Figure 5 [Fig. 5]).

Furthermore studies show that family-friendly measures benefit the employer, as they demonstrably lead to higher employee productivity. Job satisfaction and motivation of employees rise, absenteeism falls, human capital accumulation increases. Worker retention increases and thus reduces the costs of locating new workers and training. Satisfied employees feel more loyal to the company and they are more productive. There are even advantages in employee recruitment if a company can refer to family-friendly personnel policies. These recruitment factors have been confirmed by HR managers in German companies.

43% of companies, which were audited as family-friendly companies, refer to the fact that it is now easier for them to attract staff [4]. Family-friendly policies in companies, for example hospitals, are thus an essential factor for countering the skills shortage or the shortage of specialist doctors. Hospitals which have family-friendly personnel policies and which offer family-friendly services to their staff are likely to have distinct competitive advantages in the recruitment of new specialist doctors, particularly against the background of the increasing share of women in the medical profession.

Spheres of Activity

Family-oriented personnel policy has many facets and is not limited to family-friendly and family-oriented personnel policies. Each organisation has different structures and employees with different needs. Therefore family-conscious personnel policies have different target audiences and require information about the needs of employees. Communication is thus a prerequisite for the successful implementation of family-friendly measures. Studies show a clear discrepancy between the service offers in organisations and the awareness of these offers by the employees [2], [10] (see Figure 6 [Fig. 6]).

Areas for action regarding family-friendly policies in organisations range from labour and organisational issues (such as part-time work, working time accounts, housing, distance working, staff scheduling, etc.), parental leave and re-entry programs (maintaining contact, qualification maintenance, partner months, etc.), a variety of childcare services (such as holiday and emergency care, parent-child offices, parent initiatives, in-house childcare, reserved spaces, etc.) to services for families (such as offers of services close to the home, sports and health facilities, parents’ seminars, etc.).

But the demographic development is also likely to increase the importance of the issue of better balance between work and care (for example respite offers or advice and information), as will qualification and labour maintenance of the ageing workforce (for example through job design, training courses, knowledge and experience transmission, etc.). Family-friendly in the end is a general part of the overall corporate culture (management style, internal communications, external communications, etc.). A good overview of spheres of action, policies and real-world examples can be found on the website

Cost and Benefits

There are only a few published in-house calculations on the costs and benefits of family-friendly measures in individual organisations [4]. Nevertheless, the few published calculations show that family-friendliness has financial benefits.

For example, MVV Energie AG has stated that every Euro invested has led to savings of €2.50. This calculation is based on a reduction of the number of staff dropping off after parental leave from 32% to 11%, thus reducing the costs of personnel replacement. This is based on a reduction of parental leave from 32 months to 14 months, which has the effect of lowering the costs of re-integrating staff and lower illness-related costs. Gains due to the increased attractiveness of the employer and employee motivation and productivity are not included here [].

Another example is the trauma centre at Murnau, which has demonstrated financial benefits growth due to family-friendly measures. When netting out the costs and benefits, the hospital achieved a gain of €136,700 in 2007.


Family-friendly measures are one part of the solution to meeting the challenges posed by demographic and social change. With the looming shortage of physicians and the increase in the proportion of female doctors, family-conscious personnel policy is continuously gaining in importance in the medical arena and represents a strategic competitive advantage in staff recruitment, retention and productivity in hospitals.

Competing interests

The author declare that he has no competing interests.


Bundesagentur für Arbeit. Perspektive 2025: Fachkräfte für Deutschland. Nürnberg: Bundesagentur für Arbeit; 2011.
Bundesministerium für Familie, Senioren, Frauen und Jugend. Familienfreundlichkeit als Erfolgsfaktor für die Rekrutierung und Bindung von Fachkräften. Ergebnisse einer repräsentativen Umfrage unter Arbeitgebern und Beschäftigten. Berlin: Bundesministerium für Familien, Senioren, Frauen und Jugend; 2008. Zugänglich unter/available from:,did=112440.html External link
Bundesministerium für Familie, Senioren, Frauen und Jugend. Gewinnen mit Familie - Effekte von Familienfreundlichkeit. Berlin: Bundesministerium für Familien, Senioren, Frauen und Gesundheit; 2010.
Bundesministerium für Familie, Senioren, Frauen und Jugend. Herausforderung familienbewusste Personalpolitik - Vorteile für Beschäftigte und Unternehmen. Berlin: Monitor Familienforschung; 2008. Ausgabe 16. Zugänglich unter/available from:,did=121580.html External link
Bundesministerium für Familie, Senioren, Frauen und Jugend. Unternehmensmonitor Familienfreundlichkeit 2010. Berlin: Bundesministerium für Familie, Senioren, Frauen und Jugend; 2010. Zugänglich unter/available from:,did=134860.html External link
Bundesministerium für Familie, Senioren, Frauen und Jugend. Vereinbarkeit von Beruf und Familie im Krankenhaus. Berlin: Bundesministerium für Familie, Senioren, Frauen und Jugend; 2009.
Deutscher Industrie- und Handelskammertag e.V. Mitarbeiter dringend gesucht! Fachkräftesicherung, Herausforderung der Zukunft. Berlin: Deutscher Industrie- und Handelskammertag e.V.; 2010. Zugänglich unter/available from: External link
Hertie-Stiftung. Beruf und Familie - Ein Mehrwert für alle. Frankfurt: Hertie-Stiftung.
Prognos AG. Qualifizierungsbedarf 2015 und 2030 in Baden-Württemberg, im Auftrag des Wirtschaftsministeriums Baden-Württemberg. Basel: Prognos AG; 2009. Zugänglich unter/available from: External link
Schulte E. Familienfreundliche Angebote für Beschäftigte - Was keiner kennt, bringt keinen Nutzen. Stat Monatsheft Baden-Württemberg. 2008;11:14-16. Zugänglich unter/available from: External link
Statistisches Bundesamt. Bevölkerung Deutschlands bis 2060. Berlin: Statistisches Bundesamt; 2009.