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Voice through exit: Changing working conditions by independent contractors’ participation

Author

Listed:
  • Caroline Ruiner

    (Ruhr-University Bochum, Germany)

  • Maximiliane Wilkesmann

    (TU Dortmund University, Germany)

  • Birgit Apitzsch

    (Sociological Research Institute (SOFI) Göttingen, Germany)

Abstract

In the course of worldwide reforms in health care systems, flexible employment is of increasing relevance in medicine and also includes the highly skilled workforce of hospital physicians. With reference to Hirschman’s seminal work on exit , voice and loyalty , this article analyzes the phenomenon of deploying locum tenens physicians as independent contractors in hospitals. The results of two qualitative empirical studies drawing on 30 qualitative interviews show conditions and consequences of exit – voice – loyalty behavior on different levels. On the meso level of organizations, locum tenens physicians help to enforce improvements in everyday hospital practices because as independent contractors, they gain a new, more autonomous position – they receive voice through exit .

Suggested Citation

  • Caroline Ruiner & Maximiliane Wilkesmann & Birgit Apitzsch, 2020. "Voice through exit: Changing working conditions by independent contractors’ participation," Economic and Industrial Democracy, Department of Economic History, Uppsala University, Sweden, vol. 41(4), pages 839-859, November.
    • Handle: RePEc:sae:ecoind:v:41:y:2020:i:4:p:839-859
    DOI: 10.1177/0143831X17738041
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