In Danish Hospitals, departments are lead by the Medical Head of Department (MHoD), and the Head Nurse. During the recent years is has been increasingly difficult to recruit physicians to the position as MHoD. There are several considerations about the reasons. It is a major concern that the difficulties will continue, and the situation is therefore debated among physicians and in the Danish Medical Association in order to shed light on the reasons. In this paper we look at two aspects that might influence this issue: the motivation for work of the MHoD and his legitimacy in relation to the consultants in his department. We have interviewed three MHoDs, interviewed the director and chief consultant of the Association of Medical Specialists, and sent a questionnaire to 100 MHoDs throughout the country. Most of the questions we have asked relate to motivation and legitimacy. We have analysed our data using the motivation theories of Richard Ryan and Edward Deci, focusing primarily on three psychological needs – the innate needs for competence, autonomy and relatedness. With regard to legitimacy we have used the legitimacy theory of Mark Suchman, looking especially at the issue of legitimacy in relation to the highly qualified knowledge workers – the consultants. Our main results are the following: The MHoD are motivated and committed to their tasks. They experience to have the right competencies in relation to their tasks and they have good relations to employees and others. However, the job has been increasingly demanding during the recent years. The growing workload seems to be a rising problem, to such an extent, that onethird doubt whether they would have applied for their job, if they had known what it implied. The MHoDs experience to have influence. Still, a lot of decisions concerning the development of their department are made elsewhere in the organisation. Combined with growing demands for documentation, this limits their feeling of having influence. This seems to be more and more accepted as a condition of the job, but they still wish to be less controlled and to have more autonomy. Traditionally, the MHoD has been the best among equals regarding medical work. Through this he has gained and maintained legitimacy, especially among his consultants. We find that the MHoD still gains legitimacy mainly through clinical work and less so through his leadership.
|Educations||Master of Public Governance, (Executive Master Programme) Final Thesis|
|Number of pages||75|