A deeply concerning culture of abuse of power and authoritarian leadership is driving experienced physicians, particularly women, out of Germany’s hospitals, according to Susanne Johna, chair of the Marburger Bund, a physician’s association. Her stark assessment, delivered to “Tagesspiegel Background Gesundheit” paints a picture of systemic issues hindering female career progression and ultimately endangering patient safety.
The criticism stems from a survey conducted by the Hamburg regional chapter of the Marburger Bund, which revealed widespread reports of power abuse and autocratic styles among hospital leadership. Johna expressed confidence that similar results would be obtained if the survey were replicated across Germany, emphasizing that the experiences shared are not isolated incidents but rooted in structural problems. She highlighted that female physicians disproportionately bear the brunt of these toxic work environments.
The Marburger Bund intends to conduct a nationwide survey of its members focusing on power abuse, discrimination and leadership culture, with preliminary findings slated for release in Spring 2026. Johna attributed the problem to the deeply hierarchical structure prevalent in German hospitals, where junior doctors often find themselves heavily reliant on their superiors, whose decisions regarding training and daily routines can be arbitrary and driven by personal preferences. She described a culture of enforced silence, driven by the fear of repercussions from those controlling professional advancement – a phenomenon she believes ultimately harms patient care.
Despite the continued dominance of women in medical school enrollment, leadership positions remain overwhelmingly male. Currently, women represent only approximately 16% of chief physicians and W3 professorships, a disparity Johna argues perpetuates a heavily skewed training and treatment paradigm.
Exacerbating this imbalance is the conflict between career advancement and family formation, with some leaders reportedly blaming pregnancy or maternity leave as career derailers. Johna shared a personal anecdote of a supervisor once expressing disappointment upon learning of her pregnancy, effectively precluding future advancement.
While acknowledging the existence of exemplary leaders committed to positive leadership development, Johna stressed the urgency of systemic change. The outflow of talented physicians is unsustainable and, echoing trends in other sectors, hospitals need to invest in infrastructure and programs designed to retain highly skilled personnel.
Johna is calling on employers, medical chambers and state governments to take definitive action. Medical chambers should not solely issue reprimands for misconduct but also consider revoking training authorizations. State governments should prioritize hospitals demonstrating employee development programs and anti-discrimination campaigns in their healthcare reforms. While a new law may not be necessary – existing anti-discrimination legislation existing – Johna argued the critical need lies in fostering greater awareness of the problem at all levels.
