Organizational Factors' Impact on Doctor Job Satisfaction

Abstract

Job satisfaction has different perspectives. Considering the point of view of an employee, it reveals the benefits people might be looking for while taking the job. And these benefits are agreed by the employer considering their own strategies, benefits and profits. Moreover organizational factors that affect their satisfaction articulate employees’ aspiration to utilize their potential to make a valuable and meaningful contribution towards fulfilling their individual goals. From an organization’s point of view, they take up people to perform explicit jobs in order to achieve their business goals. A win -win situation happens when the organization finds people who are ready to work for the required business goals happily. In medical profession, the level of job satisfaction of doctors directly affects their attitudes towards colleagues, students and above all the patients. This paper highlights the impact of organizational factors on job satisfaction among the doctors in teaching hospitals and also suggests job satisfaction should be recognized as a measure, must to be included in quality improvement programmes and institutions must realize the importance of having satisfied employees.

Keywords: job satisfaction, teaching hospitals, doctors

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Introduction

Job satisfaction has been defined as a pleasurable emotional state resulting from the evaluation of one’s job; an affective reaction to one’s job; and an attitude towards one’s Job. In other words it describes how satisfied an individual is with his job. Job satisfaction has many variables. One may be content with one factor of job but at the same time might not be satisfied with other factor related to the same job. For example a doctor may be satisfied with his designation but may not be satisfied with work load.

Job satisfaction of a doctor has an effect on his behavior with co-workers, seniors and particularly the patient care. Quality of medical care and doctor-patient relationship is beyond doubt reliant on the level of job satisfaction. In general doctor’s effectiveness includes timely treatment, availability, the way he communicates and explains the treatments and tests to the patients and their relatives. Several studies have been taken by different researchers and it was seen doctor’s performance and behavior in the organization is related to job satisfaction. It has also been seen if the employee is satisfied with his job, organization can expect better performance from him. In case of a teaching hospital, other than all these behaviors the dissatisfaction of a doctor may extent to the point where it might affect their teaching quality and present a negative impression to the students and the new recruits under him.

Literature review

Job dissatisfaction and stress among doctors affect the quality of health care. The area under discussion of job satisfaction is of great concern due to the fact that organizational and employees’ health and welfare lies a great deal on job satisfaction (Adams et al, 2000). Various studies have ascertained that dissatisfaction with one’s job may upshot employee turnover, absenteeism, sluggishness and grievances. Improved job satisfaction, on the other hand, results in increased productivity (White, 2000). Satisfied employees tend to be more productive and committed to their jobs (Al-Hussami, 2008). In a healthcare industry, employee satisfaction has been found to be positively related to quality of service and patient satisfaction (Tzeng, 2002). Various factors that lead to dissatisfaction in doctors are an average number of working hours, work environment and salary( Kaur S. et al 2011), workload, system of promotion( Sultana A. etal 2009). Another study found perks, conducive working environment, job security, insolent behaviour, undue interference, personal protection due to law and order situation and biased attitudes etc, are some of causes of their uneasiness (Aijaz A. Sohag 2012). Singh Rajkumar G. (2013) stated that the positive performance of employee in the organization is result of his pleasing job experience. He also found Pay and compensation factors were the most important factors positively correlated with employee job satisfaction.

Rationale of proposed investigation

A number of studies have addressed job satisfaction among health care professionals. Indian studies are limited to nurses and other individual professions. Given the noticeable lack of studies addressing job satisfaction among doctors in teaching hospitals of Navi Mumbai, this study will attempt to address the gap in the literature.

Objective

To study the relationship between organizational factors and job satisfaction, among doctors working in teaching hospitals of Navi Mumbai.

Research Methodology

For the purpose of the study, the target group of doctors working in different Teaching Hospitals was selected. A total of 60 questionnaires were returned, which had questions based on their demography and organizational factors. The organizational factors consisted of Work environment, Job security, financial benefits, Non financial benefits, Pay and promotion potential, freedom to patient care, Work relationships, Use of skills and abilities, Work activities, Opportunity to develop and Time pressure.

Analysis

In the first section the respondents were asked to rate the importance of the following factors in job satisfaction while working in your organization, using five point Likert’s scale. As represented in the table 1, it showed work environment (4.1) as the most important factors required for job satisfaction, followed by freedom to work with patients (4.08), financial benefits (3.9), work load (3.8) and job organisation (3.7). Similar results were seen in a study by Sharma M. et al. among Indian physicians which stated physical work conditions, freedom to choose desired method of working, attitude of fellow workers, recognition for good work, , rate of pay, opportunity to use abilities as the factors extensively associated with their job satisfaction.

The second section asked the respondents to rate their job satisfaction for all the factors and sub factors. The first Factor under study Work activities, included variety of job responsibilities, Degree of independence associated with work roles, Workload with regard to clinical aspect, Workload with respect to teaching aspect. 73% of the respondents were satisfied with the variety of job responsibilities, 66% said they were unsatisfied with the degree of independence 72% were unsatisfied with the workload. Aijaz A. Sohag1(2012) found 76.2% doctors were found to be completely dissatisfied with their jobs. A significant portion of these doctors were found to be dissatisfied with factors like work load, conducive working environment, job security, undue interference from seniors and management.

Factors

Number of people responded ( N)

Average Rating

Unimportant

Least Important

Moderately Important

Important

Very important

Work load

N

4

5

10

21

20

3.8

%

6.66

8.33

16.66

35.00

33.33

Financial benefits

N

2

4

15

15

24

3.9

%

3.3

6.66

25

25

40

Non financial benefits

N

6

6

13

20

15

3.5

%

10

10

21.66

33.33

25

Pay and promotion potential

N

5

10

15

15

15

3.4

%

20

16.66

25

25

25

Work relationships

N

12

13

15

11

9

2.8

%

20

21.66

25

18.33

15

Use of skills and abilities

N

14

10

10

11

15

3.05

%

23.33

16.66

16.66

18.33

25

Work Environment

N

1

4

10

17

28

4.1

%

1.66

6.66

16.66

28.33

13.33

Opportunity to develop

N

13

10

11

11

15

3.08

%

21.66

16.66

18.33

18.33

25

Job organisation

N

6

5

10

18

21

3.7

%

10

20

16.66

30

35.00

Freedom of Patient care

N

2

2

10

21

25

4.08

%

3.3

3.3

16.66

35.00

41.66

Time pressure

N

2

4

12

20

22

3.9

%

3.3

6.66

20

33.33

36.66

Table 1

Second factor under consideration was ‘Financial benefits’ and it includes salary in comparison to other organizations, Annual increments, other benefits like provident fund, gratuity and provision for leave encashment. 68% of the respondents rated themselves as highly unsatisfied with the salary followed by 63% for the annual increments and leave encashment. Cozen 2001 reported that different attractions regarding job satisfaction in terms of financial gain motivates doctors at tertiary care hospital especially as it characterized by high degree of independence in work planning and decision making. Similar results were seen in a study by Tran BX etal. 2013 who investigated factors associated with job satisfaction among commune health workers. The results demonstrated that respondents were least satisfied with the salary and incentives, followed by benefit packages, equipment, and environment. Wu D. et al. 2014 also found factors which contributed most to low job satisfaction were low income and long working hours.

‘Non financial benefits’ refers to other benefits your employer offers - flexible working hours, Insurance, health care, child care etc, recognition by the superiors, and reward for research work. 61% of the respondents were very highly unsatisfied with their work recognition. 74% of them were unsatisfied with the rewards for the research work. Selebi C., & Minnar A. (2007) conducted a survey in South Africa and found that all doctors experienced low satisfaction with responsibility, opportunity for creativity and innovation, independence, and recognition. Another study by M I Rehman, R Parveen (2008) among teachers of Bangladesh found the areas of pay, promotion and recognition from authority were the major characteristics of the job satisfaction profiles of dissatisfied faculty members.

‘Pay and promotion potential’, the next factor consisted of Salary, Opportunities for Promotion, promotion transparency, fairness of the salary package, Incentives for high achievements. 72% of the total respondents were unsatisfied with the opportunities for promotion followed by transparency of the system, where 70% of the respondents were unsatisfied. The results coincided with the results of the study by Bhatnagar K., & Srivastava K. (2011) to measure job satisfaction status of medical teachers. Poor utilization of skills, poor promotional prospects, inadequate pay and allowances combined with work conditions were the factors contributing toward job dissatisfaction. Sultana A. et al. 2009 also found most of the respondents were not satisfied with system of promotion.

‘Work relationships’ consisted of variables like relationships with employers, relationships with seniors and colleagues, participation in decision making, colleagues support, Professional stimulation. 63% of the respondents were satisfied with their relation with their colleagues and 61% of the same said they can depend on their colleagues for support. But 68% said they were not involved in the decision making. Persefoni Lambrou et al. (2010) investigated motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. The survey revealed achievements, remuneration, co-workers and job attributes as the four main motivators. Different studies by M. Willis etal. (2008) and L. Fogarty 2014 reported similar results in low- and middle-income countries. In addition it was also observed that acknowledgement for work and relationships with colleagues have a high impact on job satisfaction directing to more positive work environment.

Next factor understudy was ‘Use of skills and abilities’ and had variables, scope to practice and learn new skills, freedom to decide the work, freedom to initiate changes. Majority of the respondents were not satisfied with the use of skills and abilities. Similar results were seen in different studies conducted by Cozens 2001 and Bhatnagar K. & Srivastava K. (2011) which indicated that job satisfaction level which was mostly found as “not satisfied” was related with non-availability of facilities for the improvement of qualifications or poor utilization of skills. 61% of the respondents were satisfied with the freedom to decide the work. Abida S. et al. 2009 found 64.6% respondents in Rawalpindi Medical College and teaching hospitals were satisfied with the freedom to choose their method of work.

Next factor labeled as ‘Work Environment’ consisted of variables including safety of working place, infrastructure, satisfaction over a communication channel, resources adequacies, volume, variety and quality. Among these 68% of the respondents were highly unsatisfied with the infrastructure and majority of them mentioned this hindered the delivery of health care.73% of the respondents were satisfied with the volume and variety of work. Around 58% were not satisfied with the communication channels being used. A similar result was seen in a study conducted in Tanzania by Leshabari M. T et al (2008), which reported poor job satisfaction in their health system due to poor rewards system, discouraging working environment and weak communications in the staff. Cozen 2001 found inadequate resources at doctor’s disposal might be one of the factors causing ‘dissatisfaction. Madaan (2008), explored Job Satisfaction among the medical faculties and residents of a tertiary care hospital, and revealed that salary, lack of incentives, poor working environment followed by inadequate infrastructural facilities were the major reasons dissatisfaction among doctors.

‘Opportunity to develop’’ consisted of variation in work, Support for additional training and education, financial assistance to attend academic conferences. 71% of the respondents were not satisfied with the opportunities provided to them. Nirpuma Madaan (2007), in her survey found Nearly 2/ 3rd of the responding doctors are happy with their jobs, but would appreciate a raise in salary and the availability of greater opportunity to grow for a more fulfilling professional life. Sharma M. et al. (2012) fund opportunity to use abilities was one of the factors extensively associated with job satisfaction of physicians.

‘Job organisation’ consisted of variables including shift length, Job description, Organisation structure, and satisfaction over call procedure. 68% of the respondents were highly unsatisfied with the length of the work shifts. Similar results were seen in a study conducted in a tertiary hospital in Delhi by Kaur S. etal. 2009 and another study by Taha N. and Amal S. 2013 in Al-Kadhimiya Teaching Hospital’s where nearly 50% doctors indicated dissatisfaction with the average number of working hours per day. In the current study 66% were not satisfied with the job description given to them. 63% of the respondents, majority of which were residents, were unsatisfied with the call rotation procedure. ‘Freedom to Patient care’ which included freedom to handle patient, sufficient time for each patient, physical and staff resources to take care of patients. 61% of them were satisfied with the freedom to handle patient but said they do not sufficient time for each patient. 59% responded that they were unsatisfied with the physical and staff resources available to them. In his study Deshwal, P. (2011) also suggested medical faculty members should get freedom in their work as it was a big cause of dissatisfaction among the doctors in the medical colleges of different universities in Uttar Pradesh. Abida S et al. 2009 found 64.6% were satisfied with the freedom to choose their method of work. Bjorvell (2002) studied job satisfaction of 153 hospital staff members including physicians, registered nurses, nurse assistants and aides, which revealed them as less satisfied with help received from superiors and sufficient time for patient care.

‘Time pressure’ consisted of many non-clinical tasks that need to do spend more time doing documentation and paperwork and sufficient time to sleep. 66% of the respondents reported unsatisfied with time pressure, and majority of them said they were spending lot of time for non clinical tasks and documentation. Mosadeghrad AM et al (2011) found too much of work, shortage of staff, time pressure, were the major factors with which the respondents were dissatisfied with. Different studies by (Fanny 2012, 2013) found more than half of the doctors reported disturbed work-life balance, reduced productivity, work quality, and prolonged fatigue level, sleepiness and extreme tiredness.

Conclusion

The study reveals doctors have low job satisfaction overall. Doctors play the major role in health care industry and are the first ones who are thought about when we talk about health care and thus it is necessary that their needs have to be taken care and a better working environment is created for them to work with utmost job satisfaction and content, the result of which would be a high quality care. It is suggested to that teaching hospitals need to improve infrastructure, develop a fixed criteria based and transparent promotion policy, raise their salaries and create opportunities for their medical professionals as it would also lead to raise Job satisfaction of young entrants making the way for effective delivery of health care.

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