Progressively larger hospitals, departments, and workplace collaboratives, along with the constant development in the healthcare system and increasing demands on its services, have challenged hospital management. In an effort to improve conditions for hospital managements, the 2021 collective agreement for physicians introduced a new position structure. This structure provides the possibility to establish new positions for senior consultant physicians, allowing them to, among other things, be assigned formal managerial responsibility for research, education, quality, and staff and unit management. The previous positions of senior consultant physicians have then changed title to chief physicians with overall managerial responsibilities. These changes potentially shift the distribution of leadership authority, implying that the medical management of hospital departments in the future will consist of a management team including both senior consultant physicians from the department and the chief physician. A key feature of the reform is that, within the overall framework, hospitals and departments have considerable autonomy to organise themselves in the way they believe makes the most sense.
Generally, there is a need for studies examining what influences the distribution of leadership authority in highly specialised public organisations, and how this distribution affects both leaders and staff in such organisations. The implementation of the renewed medical leadership structure introduced through the 2021 collective agreement provides a unique opportunity to examine this.
Accordingly, the aim of this project is:
The above is examined through a survey conducted in 2023 among chief physicians, senior consultant physicians, and physicians without managerial responsibility, as well as a follow-up survey among chief physicians and senior consultant physicians in 2026. The 2023 survey is informed by an interview study and by previous research.
The project is headed by Professor Christian Bøtcher Jacobsen (christianj@ps.au.dk) and Assistant Professor Mathias Rask Østergaard-Nielsen (mathiasoestergaard@ps.au.dk). The first part of the project, which took place in 2023–2025, was conducted in collaboration with VIVE and the University of Southern Denmark, while the second part of the project, which will take place in 2026–2027, is conducted in collaboration with the University of Southern Denmark.
