Germann Barbara Jarmila, Frey Julia, Soltermann Alain, Küllenberg Janna
School of Applied Psychology, FHNW University of Applied Sciences and Arts Northwestern, Olten, Switzerland.
Swiss Med Wkly. 2025 Aug 5;155:4205. doi: 10.57187/s.4205.
While part-time employment is commonly discussed as a way to recruit and retain physicians, the average workload of hospital physicians has barely decreased in the past decade, and hospitals face persistent difficulties in adopting part-time work. This study aims to examine the attitudes of hospital physicians across various specialties and positions towards part-time employment, and to identify factors that hinder or facilitate the successful implementation of part-time arrangements in hospital settings.
We conducted an exploratory mixed-method study, combining a qualitative interview study with reflexive thematic analysis of 19 participants, and an online quantitative survey of 553 physicians. Data were collected between August and November 2023 in seven public hospital organisations in Switzerland.
The quantitative data revealed a widespread desire for workload reduction across all roles, specialties, age groups and sexes, with an average ideal workload of 81%. Contrary to some statements in the qualitative interviews, the youngest cohort of physicians reported the highest ideal workload (88%). Most respondents (60%) believed they would be granted a workload reduction, yet an equal percentage at least partially agreed that working part-time would negatively impact advancement opportunities within the hospital. Other concerns about part-time work included the additional workload it might place on colleagues (76.5%) and a potential decline in medical quality (17.5%). These concerns varied across specialties and positions. The qualitative interviews identified both organisational and cultural barriers to the implementation of part-time work for hospital physicians, such as complex scheduling, additional effort and the prevailing "ideal physician norm" that prioritises physical presence and professional obligations over personal life. Conversely, factors facilitating part-time work included a supportive culture for part-time models and flexible organisational structures and processes.
Addressing current perceptions of physicians' part-time work may be an essential first step towards establishing sustainable part-time solutions in hospitals. This includes the assumption that a physician's competence depends solely on his or her availability. Furthermore, the redesign of workplace structures, including shift schedules and training programmes, may be necessary to accommodate varying workloads. When accommodating part-time solutions for hospital physicians, implementing one-size-fits-all solutions may not be expedient, given the varying circumstances of different specialties and positions. Therefore, we recommend that solutions be tailored to the specific needs of each clinic and developed through a participatory process.
虽然兼职工作常被视为招募和留住医生的一种方式，但在过去十年中，医院医生的平均工作量几乎没有减少，医院在采用兼职工作方面仍面临持续困难。本研究旨在调查不同专业和职位的医院医生对兼职工作的态度，并确定阻碍或促进医院成功实施兼职安排的因素。
我们开展了一项探索性混合方法研究，将对19名参与者进行的定性访谈研究及反思性主题分析与对553名医生的在线定量调查相结合。数据于2023年8月至11月在瑞士的七个公立医院组织中收集。
定量数据显示，所有角色、专业、年龄组和性别对减少工作量都有广泛的需求，平均理想工作量为81%。与定性访谈中的一些说法相反，最年轻的医生群体报告的理想工作量最高（88%）。大多数受访者（60%）认为他们会被批准减少工作量，但同样比例的人至少部分同意兼职工作会对医院内部的晋升机会产生负面影响。对兼职工作的其他担忧包括可能给同事带来额外工作量（76.5%）以及医疗质量可能下降（17.5%）。这些担忧因专业和职位而异。定性访谈确定了医院医生实施兼职工作的组织和文化障碍，如复杂的排班、额外的工作量以及将出勤和职业义务置于个人生活之上的普遍“理想医生规范”。相反，促进兼职工作的因素包括对兼职模式的支持性文化以及灵活的组织结构和流程。
解决当前对医生兼职工作的看法可能是在医院建立可持续兼职解决方案的关键第一步。这包括认为医生的能力仅取决于其可工作时间的假设。此外，可能需要重新设计工作场所结构，包括轮班时间表和培训计划，以适应不同的工作量。在为医院医生提供兼职解决方案时，鉴于不同专业和职位的情况各异，采用一刀切的解决方案可能并不合适。因此，我们建议根据每个诊所的具体需求量身定制解决方案，并通过参与式过程来制定。
