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Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Physician emigration from Germany: insights from a survey in Saxony, Germany

Authors: Birte Pantenburg, Katharina Kitze, Melanie Luppa, Hans-Helmut König, Steffi G. Riedel-Heller

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

Physician migration has been gaining attention worldwide. In Germany, physician migration became a topic of interest in the context of the discussion about a shortage of physicians, for which one contributing factor may be physicians leaving the country. However, there is a lack of literature on “push” factors causing German physicians to leave. The present study seeks to provide current data in an effort to promote the identification of “push” factors motivating German physicians to emigrate.

Methods

In a cross-sectional survey, all physicians ≤40 years of age registered with the State Chamber of Physicians of Saxony, Germany (n = 5956) were sent a paper-pencil questionnaire examining socio-demographics, job satisfaction, the wish to emigrate, and the likelihood of moving abroad in the near future. Variables associated with the wish to emigrate were assessed with multivariate logistic regression models.

Results

Approximately 30% of participants wished to emigrate. The favourite destination countries were Switzerland, Scandinavian countries, and Australia or New Zealand. Of participants wishing to emigrate, approximately 52% thought it likely to emigrate for a limited, and 15% for an unlimited period of time. Participants with the wish to emigrate were significantly less satisfied with their job situation as compared to physicians without the wish to emigrate, the one exception being their “relationship with patients”. The three aspects with the highest difference in satisfaction were the overall work situation, followed by work load, and time for family, friends, and leisure activities. Being a woman, being in a relationship, and having children were associated with a lower chance for wishing to emigrate. Higher satisfaction with the factors “work load”, “patient care”, and “structural aspects” was also associated with a lower chance for wishing to emigrate.

Conclusions

Emigration seems to be a viable option for at least a subset of physicians. Preventive measures should address modifiable determinants associated with an increased chance for wishing to emigrate, such as job satisfaction. Especially satisfaction with the factor “work load” seems to play a crucial role as a “push” factor for physician emigration.
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Literature
10.
go back to reference Ognyanova D, Busse R. A destination and a source: Germany manages regional health workforce disparities with foreign medical doctors. In: Wismar M, Maier CB, Glinos IA, Dussault G, Figueras J, editors. Health Professional Mobility and Health Systems. Evidence from 17 European countries. Brussels: European Observatory on Health Systems and Policies; 2011. p. 211–41. Ognyanova D, Busse R. A destination and a source: Germany manages regional health workforce disparities with foreign medical doctors. In: Wismar M, Maier CB, Glinos IA, Dussault G, Figueras J, editors. Health Professional Mobility and Health Systems. Evidence from 17 European countries. Brussels: European Observatory on Health Systems and Policies; 2011. p. 211–41.
11.
go back to reference Kopetsch T. The migration of doctors to and from Germany. J Public Health. 2009;17:33–9. Kopetsch T. The migration of doctors to and from Germany. J Public Health. 2009;17:33–9.
19.
go back to reference Mejía A, Pizurki H, Royston E. Physician and nurse migration: Analysis and policy implications report of a WHO study. Albany: World Health Organization; 1979. Mejía A, Pizurki H, Royston E. Physician and nurse migration: Analysis and policy implications report of a WHO study. Albany: World Health Organization; 1979.
22.
go back to reference Ognyanova D, Young R, Maier CB, Busse R. In: Buchan J, Wismar M, Glinos IA, Bremner J, editors. Why do health professionals leave Germany and what attracts foreigners? A qualitative study, Health Professional Mobility in a Changing Europe. New dynamics, mobile individuals and diverse responses: European Observatory on Health Systems and Policies; 2014. p. 203–32. Ognyanova D, Young R, Maier CB, Busse R. In: Buchan J, Wismar M, Glinos IA, Bremner J, editors. Why do health professionals leave Germany and what attracts foreigners? A qualitative study, Health Professional Mobility in a Changing Europe. New dynamics, mobile individuals and diverse responses: European Observatory on Health Systems and Policies; 2014. p. 203–32.
27.
go back to reference Köhler S, Kaiser R. Junge Ärzte – Ausstieg aus der Patientenversorgung? Hessisches Ärzteblatt. 2003;9:462–4. Köhler S, Kaiser R. Junge Ärzte – Ausstieg aus der Patientenversorgung? Hessisches Ärzteblatt. 2003;9:462–4.
28.
go back to reference Gesellschaft für Forschung und Beratung im Gesundheits- und Sozialbereich. Studie zur Erfassung, Analyse und Auswertung von Daten über nicht ärztlich tätige Ärztinnenund Ärzte im Freistaat Sachsen unter Gender Mainstreaming Gesichtspunkten mit dem Ziel der Erarbeitung von (Wieder-) Einstiegsprogrammen für diese Ärztinnen und Ärzte. 2006. Final report. Study commissioned by Sächsisches Staatsministerium für Soziales, Dresden, Saxony, Germany. Gesellschaft für Forschung und Beratung im Gesundheits- und Sozialbereich. Studie zur Erfassung, Analyse und Auswertung von Daten über nicht ärztlich tätige Ärztinnenund Ärzte im Freistaat Sachsen unter Gender Mainstreaming Gesichtspunkten mit dem Ziel der Erarbeitung von (Wieder-) Einstiegsprogrammen für diese Ärztinnen und Ärzte. 2006. Final report. Study commissioned by Sächsisches Staatsministerium für Soziales, Dresden, Saxony, Germany.
30.
go back to reference Bovier PA, Perneger TV. Predictors of work satisfaction among physicians. Eur J Pub Health. 2003;13:299–305.CrossRef Bovier PA, Perneger TV. Predictors of work satisfaction among physicians. Eur J Pub Health. 2003;13:299–305.CrossRef
38.
go back to reference Vanasse A, Scott S, Courteau J, Orzanco MG. Canadian family physicians’ intentions to migrate: associated factors. Can Fam Physician. 2009;55:396.PubMedPubMedCentral Vanasse A, Scott S, Courteau J, Orzanco MG. Canadian family physicians’ intentions to migrate: associated factors. Can Fam Physician. 2009;55:396.PubMedPubMedCentral
39.
go back to reference Klein D, Hofmeister M, Lockyear J, Crutcher R, Fidler H. Push, pull, and plant: the personal side of physician immigration to Alberta, Canada. Fam Med. 2009;41:197–201.PubMed Klein D, Hofmeister M, Lockyear J, Crutcher R, Fidler H. Push, pull, and plant: the personal side of physician immigration to Alberta, Canada. Fam Med. 2009;41:197–201.PubMed
46.
go back to reference Mache S, Vitzthum K, Klapp BF, Groneberg DA. Stress, health and satisfaction of Australian and German doctors--a comparative study. World Hosp Health Serv. 2012;48:21–7.PubMed Mache S, Vitzthum K, Klapp BF, Groneberg DA. Stress, health and satisfaction of Australian and German doctors--a comparative study. World Hosp Health Serv. 2012;48:21–7.PubMed
47.
go back to reference Simmgen M. Why German doctors enjoy British medicine. Clin Med (Lond). 2004;4:57–9.CrossRef Simmgen M. Why German doctors enjoy British medicine. Clin Med (Lond). 2004;4:57–9.CrossRef
Metadata
Title
Physician emigration from Germany: insights from a survey in Saxony, Germany
Authors
Birte Pantenburg
Katharina Kitze
Melanie Luppa
Hans-Helmut König
Steffi G. Riedel-Heller
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3142-6

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