Work situation of rheumatologists and residents in times of COVID-19 :  Findings from a survey in Germany <span class="so-article-trans-title" dir="auto"> Translated title: Arbeitssituation von Rheumatolog*innen und Weiterbildungsassistent*innen in Zeiten von COVID-19 : Ergebnisse einer Erhebung in Deutschland </span>

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Abstract

Background and objective

The work situation is an important dimension of professional life and wellbeing, and a policy lever to strengthen recruitment and retention. This study aims to explore the work situation of physicians and residents in internal medical rheumatology, considering the impact of the coronavirus pandemic COVID-19.

Methods

A questionnaire-based online survey was conducted in early 2021 at the Hannover Medical School, supported by the German Society of Rheumatology. Target groups were all rheumatology physicians and residents in Germany. The main areas of investigation included work hours, task delegation, and collaboration; workload and mental health issues; discrimination and sexual harassment experiences; and the impact of COVID-19. Descriptive statistical analysis was performed for the standardized items and qualitative content analysis for the free-text information.

Results

The respondents ( n = 101) expressed positive attitudes towards cooperation and task delegation to medical assistants, especially those specialized in rheumatology, while attitudes towards cooperation with GPs pointed to blockades. There was a strong mismatch between actual and desired work hours both in the group of women and in the group of men. 81% rated their workload as high or very high; every sixth rheumatologist has suffered from stress or burnout syndromes at least once in the past. Experiences of gender discrimination and sexual harassment/violence were frequently reported, mostly by women. COVID-19 was an amplifier of stress, with major stressors being digitalization and increased demand for communication and patient education.

Conclusion

There is an urgent need to improve the work situation of rheumatologists and reduce stress and mental health risks.

Supplementary Information

The online version of this article (10.1007/s00393-021-01081-5) includes the survey questionnaire in German.

Translated abstract

Hintergrund und Fragestellung

Die Arbeitssituation ist ein wichtiger Aspekt im Berufsleben und für das Wohlergehen und ein politischer Hebel, um den Verbleib im Beruf sowie die Fachkräfterekrutierung zu verbessern. Ziel dieser Studie war es, die Arbeitsbedingungen internistischer Rheumatolog*innen und Weiterbildungsassistent*innen unter Berücksichtigung der Auswirkungen der Coronavirus-Pandemie COVID-19 zu untersuchen.

Methode

Eine fragebogenbasierte Online-Erhebung wurde Anfang 2021 an der Medizinischen Hochschule Hannover durchgeführt, unterstützt von der Deutschen Gesellschaft für Rheumatologie. Zielgruppe waren alle Rheumatolog*innen und Weiterbildungsassistent*innen in Deutschland. Thema waren Arbeitszeiten, Kooperation und Delegation, Arbeitsbelastungen und Burnout-Syndrome, Diskriminierung und sexuelle Belästigung sowie Auswirkungen von COVID-19. Standardisierte Items wurden deskriptiv und Freitextinformationen mittels qualitativer Inhaltsanalyse ausgewertet.

Ergebnisse

In der Untersuchungsgruppe ( n = 101) zeigten sich positive Einstellungen zu Kooperation und Aufgabendelegation an medizinische Fachangestellte, v. a. Rheumatologische Fachassistenz, während die Einstellungen zur Kooperation mit Hausärzt*innen Blockaden sichtbar machten. Die tatsächliche Arbeitszeit unterschied sich sowohl in der Gruppe der Frauen als auch der Männer sehr deutlich von der Wunscharbeitszeit. Ihre Arbeitsbelastung bewerteten 81 % als hoch oder sehr hoch; jede*r 6. Befragte war mindestens einmal in der Vergangenheit von Stress und Burnout betroffen. Diskriminierungserfahrungen und sexuelle Belästigungen waren weitverbreitet und betrafen Frauen stärker als Männer. COVID-19 erwies sich als Stressverstärker; Digitalisierung, erhöhter Bedarf an Kommunikation und Patientenaufklärung waren wesentliche Stressfaktoren.

Schlussfolgerungen

Die Arbeitssituation von Rheumatolog*innen sollte dringend verbessert werden, um Stress und Gesundheitsrisiken zu verringern.

Related collections

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The Triple Aim-enhancing patient experience, improving population health, and reducing costs-is widely accepted as a compass to optimize health system performance. Yet physicians and other members of the health care workforce report widespread burnout and dissatisfaction. Burnout is associated with lower patient satisfaction, reduced health outcomes, and it may increase costs. Burnout thus imperils the Triple Aim. This article recommends that the Triple Aim be expanded to a Quadruple Aim, adding the goal of improving the work life of health care providers, including clinicians and staff.

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Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union

Ellen Kuhlmann, Pavel V Ovseiko, Christine Kurmeyer … (2017)

Background Women’s participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). Case The percentage of female medical students and doctors in all four countries is now well within the 40–60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the ‘glass ceiling’ effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Conclusion Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.

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Author and article information

Contributors

Ellen Kuhlmann:

ORCID: http://orcid.org/0000-0002-7337-114X

kuhlmann.ellen@mh-hannover.de

Journal

Journal ID (nlm-ta): Z Rheumatol

Journal ID (iso-abbrev): Z Rheumatol

Title: Zeitschrift Fur Rheumatologie

Publisher: Springer Medizin (Heidelberg )

ISSN (Print): 0340-1855

ISSN (Electronic): 1435-1250

Publication date (Electronic): 17 September 2021

Publication date PMC-release: 17 September 2021

Pages: 1-11

Affiliations

[1 ]GRID grid.10423.34, ISNI 0000 0000 9529 9877, Klinik für Rheumatologie und Immunologie, , Medizinische Hochschule Hannover, ; OE 6830, Carl-Neuberg-Str. 1, 30625 Hannover, Germany

[2 ]Regionales Kooperatives Rheumazentrum Niedersachsen e. V., Hannover , Germany

Author notes

[Redaktion]

Ulf Müller-Ladner, Bad Nauheim

Uwe Lange, Bad Nauheim

Author information

Ellen Kuhlmann http://orcid.org/0000-0002-7337-114X

Article

Publisher ID: 1081

DOI: 10.1007/s00393-021-01081-5

PMC ID: 8448391

PubMed ID: 34535820

SO-VID: d4985d8d-d695-47af-9002-317316c89b62

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 8 August 2021

Funding

Funded by: Medizinische Hochschule Hannover (MHH) (3118)

Open Access :

Open Access funding enabled and organized by Projekt DEAL.

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