gms | German Medical Science

GMS Zeitschrift für Medizinische Ausbildung

Gesellschaft für Medizinische Ausbildung (GMA)

ISSN 1860-3572

The Round Table on the "Reconciliation of Family and Career in Healthcare"

Commentary medicine

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  • corresponding author Annette Widmann-Mauz - Deutscher Bundestag, Bundesministerium für Gesundheit, Parlamentarische Staatssekretärin, Berlin, Deutschland

GMS Z Med Ausbild 2012;29(2):Doc37

doi: 10.3205/zma000807, urn:nbn:de:0183-zma0008077

This is the translated version of the article.
The original version can be found at: http://www.egms.de/de/journals/zma/2012-29/zma000807.shtml

Received: March 28, 2011
Revised: May 26, 2011
Accepted: June 3, 2011
Published: April 23, 2012

© 2012 Widmann-Mauz.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Background

It is one of the key tasks of health policy to ensure comprehensive and adequate medical care for the population. To this end, skilled and motivated staff is essential. Already there are complaints that not all departments and regions have sufficient medical and nursing staff. This situation will worsen in the coming years, especially through demographic trends as people in our country living longer and as older people use more medical services. Studies therefore see an increasing demand for medical services with a simultaneous decrease in qualified professionals in the medical and nursing sector [1].

An important factor for attracting the needed next generation of medical and nursing professionals in the healthcare system and to retain them long-term is a balanced work-life environment for employees. Improving the compatibility of family and career for all healthcare professionals is therefore of increasing importance. The Federal Ministry of Health (BMG) will look for solutions in consultation with all stakeholders. The goal is to develop ideas and concrete measures to enable better offers for people who work in the healthcare system [2].


The Round Table

“Reconciliation of Family and Career in Healthcare”

Under my leadership two round tables were held in 2010 on the “Reconciliation of Family and Career in Healthcare” discussing the problems of reconciling work and family life. It was attended by representatives of hospitals and the medical profession including the Federation Female Doctors, nursing staff, care facilities, the unions, and the federal states and the umbrella organisation of health insurers. All parties acknowledged the necessity and urgency of creating family-friendly conditions in the healthcare system.

In December 2010 the first joint recommendations by the participants on how to better reconcile work and family in healthcare were formulated. It calls for the removal of barriers in under- and postgraduate education, the provision of targeted information on best-practice initiatives in hospitals and GP surgeries.


Under- and Postgraduate Education

The participants agreed that all possibilities should be exploited to facilitate studying full-time. But greater flexibility in the practical study modules was also considered necessary. The BMG is therefore currently considering if and to what extent changes in the training arrangements are required. The federal states should check to see if educational regulation needs to be adapted. Hospital boards, universities and university hospitals were asked to develop best-practice models for a good career-family balance, including better offers for part-time postgraduate education.

The postgraduate teaching regulations of the medical federations already permit part-time postgraduate studies but to date the uptake is low. The federal and other medical chambers should encourage better use of these opportunities. The state medical federations should unify their regulations on postgraduate teaching to prevent recognition problems when moving between states. Conditions must be created in the chamber districts, hospitals and GP surgeries to allow for more part-time postgraduate training. This in particular includes training structures, the development of interlinked training and implementing measures for the staff which support the compatibility of career and family.

Postgraduate training is designed differently in the healthcare professions. If postgraduate training takes place in the workplace, training regulations differ from state to state and only some have provisions for part-time studies. The states should therefore unify their regulations and provide for part-time models. In particular, the recognition of completed units must be facilitated.

The protection of expectant and nursing mothers is of great importance. But maternity protection regulations should not interfere unduly with under- and postgraduate education. The BMG has therefore referred the concerns of the Round Table to the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth for a review of the maternity provisions and if necessary to revise them and asked the Ministry to set up a working group at the federal and state level.


Federal Covering Agreements and Licensing Regulations

In addition, the partners of federal covering agreements will be asked, following the recommendations of the round table, to consider whether the content of the federal covering agreements is in conflict with the aim of reconciling work and family. The admissions regulations will also be scrutinized. In particular the option for female contract physicians for extending replacement coverage due to childbirth from 6 to 12 months will be investigated. The possibility of employing a relief assistant1 for raising children up to the age of 36 months and nursing care of relatives for up to 6 months will be examined. Associations of statutory health insurance physicians should be able to extend the 36/6 month period. Furthermore, time spent raising children or caring for relatives leading to an interruption in the employment should be notionally considered in the selection for filling posts of contracting physician.


Provision of Targeted Information on the Best-practice Initiatives

The interested parties thought that better ways of exchanging information about experiences between the bodies and for the information of the employees were needed which could demonstrate to interested parties what concrete measures could look like for a better balance between family and career at the respective workplace.

Many healthcare facilities already have a variety of opportunities for creating a good environment for family-friendly jobs. However, these should be more widely used. This includes the expansion of childcare, making re-entry for employees after parental leave easier and improvements in work organization.

To reinforce this exchange of experiences, the BMG has been funding a project since October 2009 which aims to collect exemplary models of task restructuring in hospitals and to publish these on an internet platform. Apart from researching task restructuring, the project will also identify approaches for better reconciliation of career and family and age-appropriate work in hospitals. The project is coordinated by the German Hospital Federation (DKG). The initial piece of the project was a recent survey of all hospitals in Germany. The project’s advisory committee then used criteria they had developed to identify appropriate models which should be looked at more closely using qualitative interviews and then published on the platform. Initially it is expected that the platform will host between five and eight models for each of the topics. The internet platform (http://www.pflege-krankenhaus.de/) will be continuously expanded with projects which apply for inclusion on the platform and which were rated as exemplary.

Under the guidance of the National Association of Statutory Health Insurance Physicians (KBV), the outpatient sector is also working on an internet platform and the creation of a brochure on the exchange of good solutions. A survey of 12,500 medical students carried out by the CBD in the summer of 2010 showed that the reconciliation of career and family is top of the list in terms of expectations of the future of their careers. The results were the same whether the subsequent activity was planned to be in the outpatient or inpatient sector. Although independent outpatient care offers special opportunities to reconcile career and family, it also offers obstacles which in many cases could be eliminated through appropriate counselling and support. As part of the supply exhibition “The Future of Medical Practice” in May 2011, concrete examples of a successful balance between family and work were presented, along with information offers for independent physicians, psychotherapists and their employees.


Summary

It turns out that family-friendly employers in the health sector are especially characterised by the fact that family-friendly working conditions are part of the company’s philosophy and are on offer. This means it is not just about isolated actions, such as offering a company kindergarten. Instead, the compatibility of work and family should play a significant role in all organizational decisions. In addition to promoting team-oriented work and dismantling hierarchies, I consider the introduction of modern working hours with reliable and flexible working hours for part-time positions as particularly important. Since the demographic change in particular will raise the need for medical personnel in hospitals, coupled with the continuing increase of the proportion of female medical graduates, taking appropriate action is unavoidable. Politics on the whole can only initiate such conditions. The biggest responsibility lies with the decision makers on site. We already know that institutions which are already making efforts towards employee-oriented work organization have much better chances of filling vacancies and to retain qualified employees in the long term. Through initiatives like the round table, the BMG contributes to supporting the necessary change in thinking and the sharing of promising approaches.

If we wish to counteract the projected shortages of physicians and nurses and to ensure comprehensive medical care in the future, then all managers in the healthcare system must take action. It is important that all involved parties develop their imagination and creativity so the desire to reconcile career and family is not seen as an intrusion but rather as an enrichment and an opportunity to explore new avenues.

For this reason, I will send out invitations for a further meeting of the round table in the second half of 2011 so we can continue the fruitful collaboration with the experts. It will enable us to exchanges news on the state of the implementation of the recommendations and to debate if further action needs to be taken. It is conceivable, for example, that the employees’ perspective on existing family-friendly working conditions should be given greater attention. I would consider this very helpful.


Note

1 Editors note: According to § 32 Sect 2 Sentence 2 of the Medical Licensure Act the purpose of a relief assistant is securing the statutory health insurance physician coverage if the physician cannot fulfil these duties, for example due to health limitations. The employment period is fixed.


Competing interests

The author declares that she has no competing interests.


References

1.
Jerg-Bretzke L, Limbrecht K. Wo sind sie geblieben? - Eine Diskussion über die Positionierung von Medizinerinnen zwischen Karriere und Beruf. GMS Z Med Ausbild. 2012;29(2):Doc19. DOI: 10.3205/zma000789 External link
2.
Fegert JM, Niehues J, Liebhardt H. Familienfreundlichkeit in der Medizin. GMS Z Med Ausbild. 2012;29(2):Doc38. DOI: 10.3205/zma000808 External link