title: [Career perspectives of hospital health workers after maternity and paternity leave: survey and observational study in Germany].
abstract: OBJECTIVE
  A term of maternity and paternity (parental) leave becomes frequent on the career paths of medical personnel. Hospitals are highly competitive environments. The question employees universally face is how such a leave will alter their personal work situation and prospects upon return.
  
  
  METHODS
  We questioned 709 leave-takers and 88 department heads of a German university hospital (2009-12; full data sets: n = 406 and n = 63) about their experiences. This data was validated by epidemiology data extraction and expert interviews, also in a Swiss and in a Norwegian institution.
  
  
  RESULTS
  Parental leave elicited high emotionality (score: 4.0 +/- 2 out of 5). Superiors' appraisal of employees' parental leave was more positive than negative (p < 0.001, mean + 0.8 +/- 0.9 on a bipolar Likert scale (BLS) from - 2 to + 2). However, the annual labor turnover in leave takers doubled to 39 %; 51 % of leave-takers experienced significant task profile changes. 58 % of doctors thought about changing their employer and 17 % of leave-taking executives lost status after return. Employees' "power" and "influence" dropped significantly (p < 0.05; determined on BLS) whereas the "professional workload" increased (p < 0.001). Consequently, after return career perspectives (measured on a bipolar visual analogue scale from - 5 to + 5) were perceived significantly more negative than positive (p < 0.0001, mean: - 1.3 +/-  2), especially by high-commitment staff (i. e. female executives, mean: - 2.1 +/- 2, pΔ < 0.05 vs. others). These perceptions significantly influenced future choices concerning further terms of leave. The Swiss and Norwegian comparators appeared to have more liberal substitution and part-time schemes than the German institution.
  
  
  CONCLUSIONS
  A competitive hospital environment can effectively demote leave-taking medical employees in their jobs. Despite sufficient financial arrangements high-commitment staff will only take parental leave of adequate length when an institutional framework protects their status. Data support four requirements: 1. Formal recognition of the leave taker's status pre-leave. 2. Establishment of a written ("claimable") return policy. 3. Substitution scheme for each individual, preferably by a locum. 4. Redirection of funds to facilitate part-time work schemes temporarily after return.
authors: Kinderchirurgie, Klinikum Brandenburg, vorm. Medizinische Hochschule Hannover, Deutschland.
authors: C
authors: C
authors: Engelmann
authors: Institut für Management, Technologie und Ökonomie, ETH Zürich, Schweiz.
authors: G
authors: G
authors: Grote
authors: Gleichstellungsbeauftragte, Medizinische Hochschule Hannover, Deutschland.
authors: B
authors: B
authors: Miemietz
authors: Institut für Biometrie und Statistik, Medizinische Hochschule Hannover, Deutschland.
authors: B
authors: B
authors: Vaske
authors: Medizinische Soziologie, Medizinische Hochschule Hannover, Deutschland.
authors: S
authors: S
authors: Geyer
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D002322:Career Mobility; D002983:Clinical Competence; D005858:Germany; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology*; D016134:Organizational Policy; D016524:Parental Leave; D010560:Personnel Selection; D010564:Personnel, Hospital / Q000523:psychology*; D062707:Return to Work / Q000523:psychology*; D011795:Surveys and Questionnaires