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The management at Shifa International Hospital wanted to build a international standard medical facility on Pakistan targeting the elite class. The management was of the view that on order to build an international standard facility, it is important to bring in management best practices from all over the world. They failed to recognize that those best practices worked well in the other countries, which had a culture very different from Pakistan. For this reason, they hired Shehbaz Ahmed, who had a MS degree in HRM from Sydney and he implemented Human Resource Models which he had learnt in foreign countries, in Shifa International Hospital.

Every HR Manager at Shifa International Hospital tried to bring in Human Resource models that were implemented in foreign countries or the models they had studied in the foreign universities. They were trying to implement the Human Resource best practices in Pakistani, which were applicable in the foreign countries. They were so bend upon implementing the model styles of working that they even ignored the negative feedback given by the employees. For example, Aysha Ahmad, the second HR manager at Shifa International Hospital, designed such training programs in the hospitals which promoted close contact among the male and female members to promote effective communication. No doubt, the training program she designed was good, but it was not applicable in the Pakistani context, where people were not comfortable in open communication between the males and the females.

The increase in the employee dropout rate every day. Employees showing discontent with the existing Human Resource practices. Employees complaining about the training methods that goes against the cultural value of Pakistan.

Shifa International Hospital has both local as well as foreign employees working for it. The hospital started with only 35 employees but now has an employee base of about 3500 employees. Shifa International Hospital has introduced Human resource Information System, which provides the HODs immediate necessary employee information. (Shifa International Hospital) In an attempt to implement the Management Best Practices, it has failed to recognize the value of local workforce as a main resource to achieve organizational targets. It needs to bring in such management practices which are well aligned with the culture of Pakistan. Shifa International Hospital needs to develop a flexible workforce environment in which the employees can perform their work duties without losing touch with their social values. Since, there are both foreign and domestic employees, so a HRM and Management system that takes into account both the Western Management Models and the cultural values of Pakistan needs to be implemented. They need a HR manager, who has full knowledge of the Pakistani work practices and cultural values, as the core values of Shifa International Hospital include Compassion, Commitment, Teamwork, Quality, Respect and Accountability. (Shifa International Hospital )Therefore, ignoring the cultural values altogether would mean the core values are compromised as workers would not be comfortable working if work practices would not be compatible with cultural values.. Hiring someone, who can implement strategies that support the cultural values of Pakistan would be able to solve the reduce discontent of the employees with the management. There is a need to modify the Western Management model to accommodate the cultural values in Pakistan.


Management practices at Shifa International Hospital were designed by Pakistani entrepreneurs who were trained in USA, and they led the basis of its management and organizational structures on the principles of the Western organizations. Pakistani entrepreneurs show a great deal of enthusiasm to replicate foreign countries management and HRM practices without recognizing the issue of cultural differences. The use of such management practices has created a large number of problems for both the employees and the managers of the organization as well. (Saher, Podsiadlowski, & Khan, 2012)

Shifa International Hospital was founded on social obligations maintained among friends and relatives. The relatives and friends of the five founding members of Shifa International Hospital offered financial resources depending on the nature of their relationships. The close friends and relatives known as the Pakki Vartan Bhanji offered more money, whereas the distant friends and relatives, the Kachi Vartan Bhanji offered less money. Shifa International Hospital was able to develop a trustworthy team of employees because of the Vartan Bhanji. Vartan Bhanji is a system by which relationship are established by exchanging gifts, and a network of mutual help and corporation. The people belonging to this network of Vartan bhanji have certain responsibilities and in turn have certain privileges as well. This system of Vartan Bhanji is also apparent in the employee-employer relationship in the organizations in Pakistan. Employees and employers develop a social bond over the course of time. This system of Vartan Bhanji also tends to impact the Management and Human Resource Practices implemented by an organization. (Saher, Podsiadlowski, & Khan, 2012) The system of Vartan Bhanji also has influence in Shifa International Hospital. There is no need of a top-down or bottom-up line of authority, as due to Vartan Bhanji, employees and employers have certain obligations and privileges, and allows a more holistic view of the business. Since every person is aware of the responsibilities, they work independently and do their best considering it their moral obligation. The benefit of this system is that it gives solutions to complex problem faced by the organizations, since employees want the best for the organization. In Pakistan, survival of companies depends on a large extent on the social and governmental relationship, rather on the support from the countrys official system. Therefore, in order to mitigate the negative impact of this, Shifa International Hospital has adopted a management model that is a mix of the domestic model and the Western Management Model. Although, in Shifa International Hospital workers work independently, but they had also implemented Western Models of Management in the hospital. Vartan Bhanji (VB) is a system of establishing and maintaining relationship through gift exchange which is used to function as a network of mutual help and cooperation in the agrarian societies of Punjab. VB primarily exists among people belonging to a system of reference called biraderi (blood and affinal relatives), although the circles of VB relationship can be extended. The core relationship, named as Pakki Vartan (PV), is primarily maintained with close relatives, but sometimes close friends also fall in this category. On the other hand, Katchi Vartan (KV) or

courtesy relationship can be established with everyone. The people belonging to these two different types of VB have different expectations and responsibilities; and in turn enjoy different privileges. People belonging to PV (inner core) have strategic relationships and fulfilling mutual expectations (of help and support) is mandatory despite tension between or among the members. The system of VB works on two basic principles: a daughters rights in her parents home, and reciprocation of gifts or services. Lyon (2002) contends, Pakistani employ very fundamental role relationships which are learnt in the security of kin groups to deal with situations in which there is no market, political or other structural security. In line with the debate, the ingrained principles of VB also appear to influence employee and employer relations in Pakistan, as despite a limited relationship, employees maintain certain social expectations especially at time of crisis from their employer which are not part of ideal capitalistic labor relations. These expectations become more visible and strategic when work relations grow close because in this situation the idiom of family is brought to the fore. In other words, labor relationships in Pakistan are not exclusively economic work contracts; they are significant social bonds. In a recent study of human resource management practices in local and multinational organizations working in Pakistan, Khilji (2003) revealed the existence of this kind of social commitment among the workers and its impact on the human resource management practices. This highlights the relevance of VB to contemporary organization working in Pakistan. In view of the role of VB in Pakistani society and organization, it is important to consider VB to better understand organizational culture and employee behavior in service sector organizations in Pakistan. (Saher, Podsiadlowski, & Khan, 2012) A management model is the choices made by a companys top executives regarding how they define objectives, motivate effort, coordinate activities and allocate resources; in other words, how they define the work of management