Abstract
BackgroundThe growing economization of the health care system and implication of market principles in the medical field have risen new and serious questions on the meaning of the medical profession, the doctor-patient relationship and the orientation of medicine itself. The impact of the dynamic clinical structures on the doctor-doctor and the doctor-patient interaction appear even unpredictable. Therefore, the impact of market-based methods, i.e. rationalization, prioritization and rationing, on job satisfaction, motivation and team cohesion should be quantified.MethodsThe experiences of former and now retired physician executives in numerous hospitals in Saxony were determined. For this purpose, an anonymously written survey using a standardized questionnaire was conducted in the first quarter of 2016.ResultsRationalization measures were confirmed by 88% of respondents. In more than a third of cases, former executives also experienced prioritization and rationing. The impact of these management techniques on job satisfaction, motivation and team cohesion was carried out in a differentiated manner. There was a tendency to regard rationalization and prioritization measures indifferently to rather disadvantageous, while rationing was predominantly rated negatively.ConclusionsIn addition to rationalization, prioritization and rationing measures have now been part of working strategy at the hospitals. On one hand, the conceptual distinction between the terms still seems imprecise; on the other hand, a creeping and imperceptible medico-ethical transgression of the prioritization to rationing seems to have already taken place.
Highlights
The growing economization of the health care system and implication of market principles in the medical field have risen new and serious questions on the meaning of the medical profession, the doctor-patient relationship and the orientation of medicine itself
Physicians should actively and creatively contribute to the discourse [11, 13]. The perspective of those physicians and surgeons who were in leading positions in hospitals and witnessed the development phase after the implementation of Diagnosis Related Groups (DRG) is crucial
Their experiences with the measures of rationalization, prioritization and rationing are shown in a questionnaire and the impact on the parameters of job satisfaction, motivation and team cohesion are analyzed
Summary
The growing economization of the health care system and implication of market principles in the medical field have risen new and serious questions on the meaning of the medical profession, the doctor-patient relationship and the orientation of medicine itself. The impact of market-based methods, i.e. rationalization, prioritization and rationing, on job satisfaction, motivation and team cohesion should be quantified. The perspective of those physicians and surgeons who were in leading positions in hospitals and witnessed the development phase after the implementation of Diagnosis Related Groups (DRG) is crucial. Their experiences with the measures of rationalization, prioritization and rationing are shown in a questionnaire and the impact on the parameters of job satisfaction, motivation and team cohesion are analyzed
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