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Remuneration systems, employer attractiveness and demographic change: An analysis of anaesthetists in German hospitals

Abstract Healthcare systems in industrialised countries have been criticised for a number of years. Rising costs, dissatisfied patients and increasing economic pressure represent only part of the problem. A shortage of medical personnel as well as the emigration of physicians has forced hospitals to reconsider HR strategies. To recruit qualified physicians, hospitals must be attractive employers. Within the German healthcare sector, the deployment of performance management systems and variable pay for performance components is traditionally underdeveloped. Such management tools require workforce support to succeed. Studies determining exactly what contributes to a positive employer image among physicians, however, are absent from the literature. This paper addresses this by investigating the expectations of physicians regarding employer attractiveness, including the role of the pay system. The paper starts with a summary of the current situation in the German healthcare market, with a particular focus on the unique position of anaesthetists, who have a vital function within every surgical team. Based on theories about employer attractiveness, motivational theories and concepts from SHRM literature, propositions are developed to analyse the abovementioned issues. A small sample of anaesthetists from a German hospital is used in a first step to test the developed propositions. The paper concludes with a discussion.