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Purpose – The purpose of this research is to show that the Swedish health care system has undergone major changes during the last decades, which have exerted strong influence on the operational freedom of physicians. Design/methodology/approach – This study consisted of 169 physicians in management positions, who answered a questionnaire assessing the relationship between their organizational settings and their perceived wellbeing. The organizational setting was defined as contact with top management, decision‐making influence, well defined organization and whether the physician is acting as a leader. The perceived wellbeing was defined as social climate, work related exhaustion, work satisfaction, influence, development ability and supportive leadership. Findings – According to the results, organizational support improves work satisfaction and mental energy, and decreases work related exhaustion among physicians. This all leads to decreasing turnover rate among physicians. Originality/value – These results point to the importance of maintaining a positive and supportive atmosphere for physicians in their work environment in order to encourage physicians to remain and take on management positions in the health care system. Furthermore enhancing physician influence over decision making processes is important to counteract work‐related exhaustion and it might also contribute to a more efficient organization.

Female physicians have less influence over their daily work conditions and exhibit slower career advancement as compared to their male colleagues. The aim of this study is to assess the impact on individual and organizational well being from different kinds of management programs. Female physicians participating in management intervention programs were compared with a reference group of matched physicians and sickness absenteeism was significantly lower in the intervention group. No significant differences were found between the groups with regard to career advancement, individual, organizational and professional well being. Health care organizations spend a substantial amount of resources on management programs in order to improve leadership, autonomy and the work‐environment of physicians in times of increasing discontent among this key group of health care employees. Our study indicates some beneficial health effects from structured management programs but there is a need to develop and assess the efficacy of these programs further.

In Sweden, leave due to sickness was high during the 1990s. The Swedish Social Insurance Agency was able to decrease sick days in the period between 2000 and 2010 but sick days are rising again in Sweden, mostly due to psychological problems among women and partly due to their work environment. It is important to find methods to identify poor work settings to prevent absenteeism due to sickness. The paper aims to discuss these issues.

The authors created a web questionnaire focusing on the organizational setting and its impact on employee wellbeing – reported as mental energy, work-related exhaustion and work satisfaction. The questionnaire measures good and poor work environment factors to help managers improve organizational settings. The questionnaire was validated qualitatively and quantitatively.

It is possible to measure individual wellbeing in an organizational context at an early stage. The authors followed a company undergoing organizational change and identified groups at risk of developing illness.

Managers uncertain about employee mental status can measure employee wellbeing easily and cost effectively to prevent illness.

The authors created a method, statistically evaluated, to proactively identify good and poor work environments to promote healthy co-workers.