TY - JOUR
T1 - Two sides to every coin: Assessing the effects of moving physicians to employment contracts
AU - Gifford, Rachel
AU - Molleman, Eric
AU - van der Vaart, Taco
N1 - Funding Information:
Funding for this project was made possible by the Netherlands Organization for Scientific Research (grant number 022.005.020 ).
Publisher Copyright:
© 2021 The Authors
PY - 2022/1
Y1 - 2022/1
N2 - There is a growing trend of physicians becoming employees of hospital systems and employment is viewed as a mechanism to help achieve health system goals. Yet, the research is mixed on the effects of moving physicians to employment models. While the literature has traditionally placed such forms of employment relationships in opposition to professional autonomy, it has often overlooked the effects on other professional values and there is little empirical work that actually assesses how such a shift affects and is perceived by clinicians themselves. To address these gaps, we conducted a mixed method study at one hospital that recently moved all formerly selfemployed physicians to employment contracts. We interviewed physicians to understand how the shift into employment was perceived to influence their work in three domains: the patient domain, the individual domain and the organizational domain. We then conducted a follow-up survey across both formerly employed and selfemployed physicians to test our initial findings. We find both positive and negative effects in different domains, offering insights into the mixed results found in the current literature.
AB - There is a growing trend of physicians becoming employees of hospital systems and employment is viewed as a mechanism to help achieve health system goals. Yet, the research is mixed on the effects of moving physicians to employment models. While the literature has traditionally placed such forms of employment relationships in opposition to professional autonomy, it has often overlooked the effects on other professional values and there is little empirical work that actually assesses how such a shift affects and is perceived by clinicians themselves. To address these gaps, we conducted a mixed method study at one hospital that recently moved all formerly selfemployed physicians to employment contracts. We interviewed physicians to understand how the shift into employment was perceived to influence their work in three domains: the patient domain, the individual domain and the organizational domain. We then conducted a follow-up survey across both formerly employed and selfemployed physicians to test our initial findings. We find both positive and negative effects in different domains, offering insights into the mixed results found in the current literature.
UR - https://www.sciencedirect.com/science/article/pii/S0277953621008960
U2 - https://doi.org/10.1016/j.socscimed.2021.114564
DO - https://doi.org/10.1016/j.socscimed.2021.114564
M3 - Article
SN - 0277-9536
VL - 292
JO - Social Science & Medicine
JF - Social Science & Medicine
M1 - 114564
ER -