Examining the impact of job satisfaction on employee performance; A Study of medical professionals in Pakistan

Ali Raza Nemati
Riphah International University, Islamabad.

Muhammad Maqsal
Riphah International University, Islamabad.

Nouman Athar
Riphah International University, Islamabad.

Abstract
Job satisfaction and motivation are very important for the betterment of medical sector of Pakistan. The purpose of this study is to know about the job satisfaction of medical sector of Pakistan and its impact on employee’s performance. How many medical professionals are satisfied from their job and what makes them satisfied? In which environment they feel relaxed during their working hours? To focus more on facts and figures questionnaires were being used as a research tool. The questionnaires were distributed to 110 medical professionals and the results indicated that employee performance is affected by job satisfaction. Strategies discussing various dimensions of employee performances have also been discussed.

Introduction
Job satisfaction is very important for an employee, because when a person is satisfied with his/her job then he will give maximum output in his/her working hours. Job satisfaction is in regard to one's feelings or state of mind regarding the nature of their work. Job satisfaction can be influenced by a variety of factors, e.g., the quality of relationship with their supervisor, the quality of the physical environment in which they work and degree of fulfillment in their work, etc. It can also be discovered through examining the employee's values. It is good not only for employees but employers, too it increases productivity and decreases staff change day by day. For an organization, performance matters a lot of an employee as if the employee is satisfied it can give an extra effort to his work In this research we are going to get a research done on the medical sector of Pakistan in which we will get to know how they get satisfied from their job? As they save many lives and they should always be satisfied from their job as any unsatisfaction or hurry can make a person die. Job satisfaction is the contentedness of individuals with their job. Multiple factors can influence a person’s level of job satisfaction; these factors range from the level of pay and benefits, perceived fairness of the promotion system within the organization, the quality of the working conditions to leadership and social relationships. At present, government of Pakistan is paying special attention towards this sector and bringing up some good structural reforms and we are now getting up some response. We can say that if these reforms continue we will see a definite change in the job satisfaction a motivational level in medical professionals.

Literature Review
Overall job satisfaction: Soleman (2005) suggests that the mean score of job satisfaction among male and female are 64.69 and 66.4 respectively so, There is no major difference between the job satisfaction level among the males and females. Female social workers reported fewer opportunities for promotion, less quality of supervision, and higher workload than male social workers. Marianne & David (1997) find Private school teacher tends to be more satisfied then public school teacher and elementary school teachers tends to be more satisfied then secondary school teachers. Jernigan & Joyce (2005) argue when it comes to satisfaction, the supervisor’s actions and behaviors do matter. An employee’s satisfaction with his or her supervisors is an important factor associated with the person’s personal job satisfaction. Only 26% of females who participated in this study said they were promoted during the last year, compared to 43% of males who were promoted at the same period. John (2004) finds that the number of years spent in an organization is an age-related variable that has a relationship to job satisfaction. Attainment seems to be an important variable in determining the satisfaction with pay of managers in the banking industry it can predict the affective response to work (or the positive feelings toward work). The contribution of this variable to good feelings toward the job. The impact of salary differential on managerial job satisfaction. Significant differences were observed by managerial level and job satisfaction. At the senior management level were only 34 females out of 500.both female and male bank manager with master’s degree or higher, reported higher level of job satisfaction then those with bachelor’s degree or lower. Kamie (1998) finds that work plays an important part in the lives of most people. The average person who puts in a 40 hour work week, 5 hours commuting, and at least some time winding down from the workday spends a substantial portion of his or her life invested in work. As a result many studies have been done on job satisfaction. In their study Jacques & Patrice (1999) argued that making benefits attractive can favor satisfaction, but this is done to the determent of motivation. Employees who are attracted or motivated by this form of compensation seem to seek the satisfaction of a need for comfort or security. They are more satisfied with their job if it offers benefits that correspond to their expectations, but their motivation to perform will not be increased. Cecelia, Dale, and Betsy (2003) finds that it was clear that overall job satisfaction for advisors of CTSOs was motivated by personal satisfaction or recognition from others. Helen, Janet, & Warwick (1998) suggested that the sense of being less valued as professionals than they believe they deserve, would then be potentially very damaging to the ‘self ’, and satisfaction with personal life as well as to the professional at work. Andre (1996) found in this research that one factor that had

a significant impact on job satisfaction was job responsibility. Does job satisfaction increase as a result of responsibility and participation or are individuals with higher levels of motivation and job satisfaction more inclined to assume roles of responsibility? One explanation for the link is provided by the concept of flow. Increased responsibility levels may lead to satisfaction because of the greater involvement, challenge, and control. Jacques & Patrice (1999) suggested that the fix pay can have a positive influence on job satisfaction in relation to performance, skill. In fact, the more employees are satisfied with the internal equity of their fixed pay, the more then tend to be satisfied with their job. Making benefits attractive can favor satisfaction, but this is done to the determent of motivation. Employees who are attracted or motivated by this form of compensation seem to seek the satisfaction of a need for comfort or security. They are more satisfied with their job if it offers benefits that correspond to their expectations, but their motivation to perform will not be increased. Chiok (2001) found that ICU nurses with higher qualifications, tends to stand a better chance of promotion, which may also contribute to their higher job satisfaction and productivity. Too much emphasis on the leadership behavior may contribute to lower productivity and job satisfaction. Shakir, Ijaz, Arif & Tahil (2007) found that most of the doctors in all ranks and with different qualifications were not found satisfied with their job due to lack of proper service structure and low salaries. Perceived employee performance: Charles (1995) founds that in administrative situations, the excretion of negative sanctions, takes a peculiar form, the administrator has the power to punish, and dismiss hose under his authority, but there is no formal provision for the exercise by subordinates of negative sanctions against superiors. Neil & Edward (1994) suggest in their research that numerous other aspects such as personal goals, role conflict role ambiguity, clarity autonomy, task significance, job challenge, job stress, and job burnout have also been proposed as possible sources of influence on job satisfaction. Ranz, Stueve & Mcquistion (2006) found that job satisfaction decreases with increasing age of staff psychiatrists but not medical directors is particularly interesting, suggesting that staff psychiatrist positions may come to be regarded as “dead-end” over time. Psychiatrists are advised to seek promotions to program medical director positions early in their careers, since these positions are far more available, and provide equal job satisfaction, compared to agency medical director positions.Andre (1996) argues that the differences between male and female responses were evident in both the ESM and conventional survey results. Women reported lower overall levels of satisfaction. This was unexpected. Paperwork could play a role, as women rated the burden of this activity as being considerably greater than men did. If the women have greater responsibility in the home, this may also contribute to decreased levels of job-satisfaction for women who bear the dual pressure of

home and work. Although satisfaction seemed to be more associated with personal factors, the influence of environmental factors cannot be ruled out. Fiona & Barry (1997) found that different patterns emerged for each nation when individual aspects of job satisfaction were investigated. But consistent with the research literature male academic tended to b more satisfied with females with mo aspects of their job. Neil & Edward (1994) suggested that early studies of job satisfaction were justified on the assumption that increased satisfaction leads to increased productivity although this view has already been replaced by an interactionnist approach there remain several reasons of continuing research into the job satisfaction of the educational administrators. Charles (1995) found that one index of presence or absence of tension would seem to be the expression of dissatisfaction or satisfaction respectively with the situation in which I is produced. Nicholas, Sue, John & Bruce (2005) found that HR practices and commitment to organization has no substantial link with each other unless there is a real need of HR practice in any specified time. Commitment might have some other variable to join with, Satisfaction with HR practices and commitment to the organisation. Price & Lee (2003) found Casual work pattern of the nurses in Taiwan is derived from the seniors, and also from the direct doctors they are working with. Stacy & Dee (2003) found Job satisfaction and marital staus has positive link with each other in smaller term (under 12 years) the relation derastically changes in longer terms.Not talking of couples, If both are satisfied with their life the impact on job satisfaction on both are positive, on the contrary in longer terms there is no such impact of job satisfaction with marital life. Ian, Ted, & Judith (2005) concluded that Female and male theripist has equall level of satisfaction.43.6 % female and 44.5 % male are enjoing their job, the major factor used in this study is payment & timing of job. Female and male therapists: A comparison of their job satisfaction level. Keith & John (1986) suggested that the determinants of job satisfaction are estimated for PhD-level scientists in the United States across academic and nonacademic sectors. In initial estimates, female scientists report lower job satisfaction than males in academia but higher job satisfaction than males in the nonacademic sector. While academic scientists with tenure have substantially job satisfaction greater than nonacademic scientists. John & Fiona (2007) found that it is an intriguing puzzle that women lawyers, despite less desirable working conditions and blocked career advancement, report similar satisfaction as men lawyers with their legal careers Even Lawyers Get the Blues. Clive & Richard (1996) suggested in their research that a number of investigations have focused on aspects of human resource management policy and their impact on employees. The study reported here examines the extent to which the main elements of performance management systems are associated with positive employee attitudes. Questionnaire measures of performance management variables and of employee attitudes were obtained from 860 staff in nine organizations, all of which had been ascertained to be operating performance management systems the findings indicate that most elements of

performance management did contribute to positive employee attitudes. David (1986) has given this field study of 327 hospital nurses investigated the relationship between perceived satisfaction with organizational communication and job satisfaction and job performance. The researcher developed a research model incorporating nine dimensions of communication satisfaction and hypothesized their varying relationships with job satisfaction and job performance. Correlation, multiple regression, and canonical correlation analyses revealed significant positive relationships between communication satisfaction and job satisfaction, and communication satisfaction and job performance. The communication satisfaction - job satisfaction link was strong. Kenneth (1978) argue that racial issues not yet been consider in job satisfaction in military, although it has a significant role in United States military. Many blacks can not make way to higher posts. Bester & Mounton (2006) suggested that Psychologists have always been part of the service orientated careers and therefore one would expect that it is likely that their dominant career anchor would be service orientation. If this is the case, psychologists with service as their dominant career anchor are supposed to have greater job satisfaction and job involvement compared to those with different career anchors. Anthony & Hugh(2006) found that In the British culture the quitting behavior of general practitioners is not entirely dependent over the level of job satisfaction. But it varies with person to person. One might leave the organization for taking a long rest or going on a long holiday with his family or because of the single fact that it cost him a mile more then the other hospital. Richard & Dowdy (2000) founds that Regardless of managerial or nonmanagerial level, individuals working in foodservice departments of hospitels in the middle of separating foodservice and clinical functions, were more satisfied with pay and contingent rewards than all other respondents. Michael & Rex (1999) found that The newly graduated docters when asked about the job satisfaction they were actually not sure of there responsibilities they have to perform so this phenomena is directly effecting the level of job satisfaction. Paula (1996) found that there is a real link of absence rate with the job satisfaction,but mainly with the older nurses working in the crowded hospitals of U.S.A,Seprate questioneares were developed for the registered young and old nurses to gather up the problem relevent to them.

Data collection method
We have adopted a questioner method to collect the required information for our research. The data was collected in 2007 from various reputed hospitals where a large number of doctors were requited. It took a couple of weeks to collect all the questionnaires back although they were only 110 in numbers. But we wanted to provide the respondent enough time so that the response should be accurate. The main variables which were kept in view while making the questionnaire were the perceived employee performance and the job satisfaction. The sub parts of these variables were there HR issues, any intentions to leave the organization,

ambiguities in there mind about there roles and their training in the same department, where they are working.

Theoretical Framework
The dependent variable in this research is employee performance which is affected by only one independent variable that is job satisfaction. The independent variable job satisfaction directly affects the performance of an employee, if an employee will be satisfied from his/her job then he/she would perform effectively and efficiently. Job satisfaction is not only important or necessary in medical sector it plays an important role in every sector, because it directly shows results on sector’s better or bad performance. In all over the world it is generally perceived that the medical sector should always be very well satisfied from their job, so that they can pay hundred percent attentions on what they are doing? As if an unsatisfied doctor from his job checks a patient in irritation it can make a patient in serious trouble, as doctor’s attention can be somewhere else. In Pakistan very large numbers of employees male and female are not satisfied from their job in many sectors due to various reasons, which affects a lot in those sectors, and as our variable shows that an employee’s performance is directly dependent on job satisfaction. The same unsatisfaction from job occurs in medical sector of Pakistan, which is affecting its performance. Regarding job satisfaction there are many factors which cause unsatisfaction of one’s job, these factors are mostly names as salary, promotions, and working conditions. If a doctor is satisfied with these factors which will consequently improve the efficiency of the doctor. Our research has focused that what are those factors for doctors due to which they feel satisfied and perform their duty in a proper way.

Over all job satisfaction

Perceived employee performance

Hypothesis
H1: Job satisfaction is directly and positively correlate with perceived employee performance.

Results
Correlation: Perceived employee performance 1 0.363883 Overall job satisfaction

Perceived employee performance Overall job satisfaction

1

Analysis: Considering the employee performance as the dependent variable and job satisfaction as independent variable, our correlation analysis indicates that there is a positive but weak relationship between perceived employee performance and overall job satisfaction.

Regression Analysis: R square 0.132411

Coefficient
Perceived employee performance Analysis:
0.259617

t
3.867389

p
0.000198

In our research job satisfaction is our independent and perceived employee performance is our dependent variable. R square shows the relation between dependant and independent variable. Our results show that there is a weak relationship between our dependant and independent variable which means that there isn’t that much impact of job satisfaction on employee’s performance in the medical sector of Pakistan.

. Co – efficient: Constant Perceived employee performance Beta
0.259617

t 3.867389

significance 0.000198

ANOVA: F: 14.9567, Significance: 0.000198 Analysis: Keeping the employee performance as the dependent variable and job satisfaction as an independent variable, our coefficient table analysis shows that that there is a positive & strong relationship between perceived employee performance and overall job satisfaction.

Demographics Table

DEMOGRAPHICS PERCENTAGES 20-30 67 % 30.1-40 21% 40.1-50 9% 50.1-60 3% MALES 49% FEMALES 51% House officers 17% Post Graduates 36% Medical officers 21% HEAD\Surgeons\Specialist. 12% Others 14% 37% FCPS MCPS 8% FRCP 6% OTHERS 49% 0-4 Years 63% 4.1-8 Years 8% 8.1-12 Years 2% 12.1-16 Years 3%

Age
Gender

Job nature\Post

Specialization

Tenure of job

Analysis: As it can be seen by the table above that most of the respondents are ranging from the age of 20 to 30 years, as they were very much cooperative with us. The second big proportion was of the age of 30 to 40 years. We can see from the table that low age or less experienced doctors responded in very large numbers. It also indicates that the intention of new doctors towards the research. As the job post or tenure of the job increases doctors response toward other activities like research decreases. Also the non specialized doctors have responded to these questionnaires in large number. Due to sensitivity of job nature and post responsibilities they had lack of time but to eliminate this factor we provided the respondent enough time to fill up the questionnaire. It has been noticed that male doctors were very much hesitated to write their names on questionnaire as compared to female doctors.

Discussion
We conducted our research on the job satisfaction in the medical sector of Pakistan and its impact on employee’s performance. Our purpose of this research was to get to know that how doctors have been satisfied from their job? For which we used the questionnaire method, we distributed 110 questionnaires and got different responses from individuals from public and private hospitals of Pakistan such as Pakistan Institute of Medical Sciences (PIMS), Polyclinic, Rawalapindi General Hospital, Alshifa Hospital and different private clinics. From 110 questionnaires we got back 103, out of these 103 questionnaires, 100 respondents provided as right information and rest provided the fake information. The fake information has not been included in our analysis. In Pakistan females are more inclined towards medical profession and in our research we have found that there are more female doctors than males. In response to our questionnaires the female doctors were more cooperative, and they filled the questionnaires more responsibly. As it’s a general perception in our Pakistani culture that females are more satisfied with their jobs as compared to male doctors. After getting the results from our questionnaires we have been confirmed that females don’t have any intentions to leave their organizations where they are working, the reasons can be that they are satisfied from their salaries and the most important is the environment where they work. Regarding leaving organization there were very less respondents specifically in public sector those who had the intention to leave the organization because they don’t want to leave their permanent earning. And one another major reason for this response is the traditional style of public sectors people in our Pakistani culture, as once they have got job they continues to work their till to the end of their career.

The private sector doctors were much more satisfied from their job because of the factors due to which their job is being influenced, such as salary, more chances of promotion and working environment etc were proper for them. The private sector doctors seemed to be more focused on training and development as compared to the public sector doctors. In the same way we found in our research that the public sector doctors had role ambiguities but in private sector there were no role ambiguities. It has been noticed that where the doctors are satisfied from the job they pay more time to their patients, as compared to those who are not satisfied from their job. To give more time to their patients is an indicator of their performance; this is directly dependent on the job satisfaction. If we take into account the medical sector precisely then we come to know that almost all the basic element for job satisfaction are being enjoyed by doctors, but even then they are not satisfied with their jobs. Then at this point another question arises that why the private sector doctors are more satisfied as compared to the public sector. People mostly thought that it’s a devoted field and services proving field so doctors should perform well by understanding it as their moral duty as well. But they forget it that like other professions in this profession those who are performing they are human beings and their performance is directly being influenced by the percentage of their job satisfaction. The variance of job satisfaction in both males and females also matter a lot. There are some factors due to which females get satisfaction from their job, but males don’t. One of the major influences regarding job satisfaction is the working with coworkers. It all depends that if your co-workers are good, cooperative and frank with you, then you feel more comfortable pleasant and satisfactory in your environment, and even during working hours you enjoy work neither you take it as a compulsion. Then in our research we have noticed that doctors are not satisfied of the facilities they have been provided with. This also leads to their un satisfaction and ineffective performance. It has been noticed that in the public sector people are not well aware of HR practices and these practices are not important than for them, but in the private sector doctors are more focused towards HR practices. Our this research focused specifically on the Pakistani environment medical sector of Pakistan, these factors might not have been affected an American doctor for his/her satisfaction. As doctors are the one of the most important and respectable occupation all over the world. So they have been asked this question that do they feel any sense of pride while doing their job? And almost 90 % agreed and strongly agreed with that. This response has been found similar in both public and private sector hospitals.

Conclusion & Recommendations
This study actually supports up to some extent with the profession of doctors with their performance i.e. we have carried out analysis of their job satisfaction with their performance. The result of the research reveals an idea of what doctors think about their job. Going into the details, The only component of job satisfaction is considered as income, utilizing one’s skills and ability and benefits our results shows that there is also a relationship of employee performance with the satisfaction of their job although it is weak. Actually we have condensed our research with the medical sector; it might be a reason that there is weak relationship with each other. On the other hand we also found in our research that doctors always feel sense of pride in doing or performing their job. The research is carried into a culture where there is a very faint idea of studies like research. In order to generalized and validate the findings excess of research environment was needed. This study provides evidence in regard to the link between their training programs, there HR issues, intentions of leaving the organization and more over with the confusion in there duties or role with job satisfaction. This paper concludes that if medical sector and especially the public medical sector enforce a better environment of hospitals in developing countries like Pakistan. Then it could be a positive step toward the betterment of these institutions and also with the performance and ultimately the job satisfaction. This study joins a growing body of research that attempts to open the untouched parts in developing countries and especially in Pakistan that explain how and to what extent performance of a doctor is being affected by the job satisfaction. Our research also open various parts of job satisfaction relating to doctors and with there performance for further studies. We should also recommend at this point that there is no such specific research which we can find is carried out in this complex culture. So there is a wide need of broaden up this research culture and this research can be proved very fruitful if carried out nationally or we should suggest that the same study should be carried out with a large sample size in other developing countries. At this point another question arises which we would like to share and can be a part of any other research is that: in publicly governed institutions or hospitals there is always a setting which involves low pay, heavy work load, less chances of promotions and very less job security. Then why there is a very large intention of doing job into these institutes. Although it is very difficult to generalize the whole survey but it is recommended equally that the governing bodies should make a body with enough powers which could take care of the issues like HR, training programs of doctors in there

relevant field and making suitable measures which could lead to a long term tenure of doctors in single institute. Surplus amount of work should not be given to a single person as it can also become the base of leaving the organization. Organizational and individual goal setting is a very helpful activity in any organization. On the compilation of these goals the institute as well as the individual will have a feeling of satisfied performance which we can easily relates with the job satisfaction. Culture of competition of one institute with other institute is also a very healthy activity. These all activities if performed for the sake of the mapping good overall performance then it can also be related to the job satisfaction as well as the reputation of any organization.

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