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Introduction: An overview of the requirements for the head of a surgical department in Germany should be given.
Materials and methods: A retrospective literature research on surgical professional policy publications of the last 10 years in Germany was conducted.
Results: Surveys show that commercial influences on medical decisions in German hospitals have today become an everyday, predominantly negative, actuality. Nevertheless, in one survey, 82.9% of surgical chief physicians reported being very satisfied with their profession, compared with 61.5% of senior physicians and only 43.4% of hospital specialists. Here, the chief physician is challenged. Only 70% of those surveyed stated that they could rely on their direct superiors when difficulties arose at work, and only 34.1% regarded feedback on the quality of their work as sufficient. The high distress rate in surgery (58.2% for all respondents) has led to a lack in desirability and is reflected in a shortage of qualified applicants for resident positions. In various position papers, surgical residents (only 35% describe their working conditions as good) demand improved working conditions. Chief physicians are being asked to facilitate a suitable work-life balance with regular working hours and a corporate culture with participative management and collegial cooperation. Appreciation of employee performance must also be expressed. An essential factor contributing to dissatisfaction is that residents fill a large part of their daily working hours with non-physician tasks. In surveys, 70% of respondents stated that they spend up to ≥3 h a day on documentation and secretarial work.
Discussion: The chief physician is expected to relieve his medical staff by employing non-physician assistants to take care of non-physician tasks. Transparent and clearly structured training to achieve specialist status is essential. It has been shown that a balanced work-life balance can be achieved for surgeons. Family and career can be reconciled in appropriately organized departments by making use of part-time and shift models that exclude 24-h shifts and making working hours more flexible.
In today’s "new world of work," knowledge workers are often given considerable flexibility regarding where and when to work (i.e., time-spatial flexibility) and this has become a popular approach to redesigning work. Whilst the adoption of such practices is mainly considered a top-down approach to work design, we argue that successful utilization of time-spatial flexibility requires proactivity on the part of the employee in the form of time-spatial job crafting. Previous research has demonstrated that time-spatial flexibility can have both positive and negative effects on well-being, performance, and work-life balance; yet remains mute about the underlying reasons for this and how employees can handle the given flexibility. Drawing on research from work design, we posit that in order for employees to stay well and productive in this context, they need to engage in time-spatial job crafting (i.e., a context-specific form of job crafting that entails reflection on time and place), which can be considered a future work skill. We propose a theoretical model of time-spatial job crafting in which we discuss its components, shed light on its antecedents, and explain how time-spatial job crafting is related to positive work outcomes through a time/spatial-demands fit.