Job Satisfaction Among Physicians Working at Dubai Health Authority Hospitals – Dubai – UAE

Al Mazrouei A. M.¹, Al Faisal W.², Hussein H.^{2, *}, El Sawaf E.², Wasfy A.²

¹Primary Health Care Services Sector,Dubai Health Authority, Dubai, UAE

²Staff Development, Health Centres Department.Primary Health Care Services Sector, Dubai Health Authority, Dubai, UAE

Abstract

Background: In health service, job satisfaction is highly associated with staff's intention to quit, quality and efficiency of services, and patient satisfaction. It has been reported that doctors with higher job satisfaction are more likely to provide more satisfactory services and produce better therapeutic effect than those with the lower one. Objectives: To determine levels and sources of job-related satisfaction, and associated facotrs among physicians. Methodology: A cross-sectional study was conducted at the 3 main hospitals affiliated to DHA in Dubai (Rashid, Dubai, and Latifa hospitals). 550 Self-administered questionnaires were distributed to all physicians after obtaining the verbal consent, 353 of whom have responded with 64.2% response rate. Out of 353 questionnaires returned, 282 were complete and eligible for analysis. The questionnaire contained 4 sections; socio-demographic data, habits and life style, occupational data, and assessment of job satisfaction. Results: The study revealed that Physicians aging ≥ 50 years old, had significantly higher mean total satisfaction score (42.4 ± 9.1) than those aging > 40 - < 50 years old and ≤ 40 years old (37.3 ± 9.6 and 36.3 ± 11.7 respectively. UAE nationals scored higher than non UAE nationals (38.8 ± 9.4 and 37.5 ± 11.4 respectively). Regarding educational level, physicians with PhD or equivalent degree had significantly higher mean total satisfaction score than those with bachelor degree (39.7 ± 10.6 and 35.04 ± 11.4 respectively). Total years of experience, physicians with longer years of experience were significantly more satisfied (≥ 20 years; 41.8 ± 8.7) than those with less years of experience (> 10 - < 20 years; 37.5 ± 11.6 and ≤ 10 years; 35.8 ± 11.00). Conclusion: Physicians with PhD or equivalent degree and older ages (≥ 50 years old) were more satisfied. In addition, physicians with longer years of experience were significantly more satisfied. Specialty and physical activity (exercise) were significant predictors of the total satisfaction score. Moving to another hospital, changing job, having health problems, quitting job and having poor relationships with coworkers were all reported as consequences of job dissatisfaction by the physicians.

Keywords

Job Satisfaction, Physician, Dubai

Received:May 3, 2015
Accepted: May 17, 2015
Published online: June 18, 2015

@ 2015 The Authors. Published by American Institute of Science. This Open Access article is under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/

1. Introduction

The prevalence of dissatisfaction among doctors has been given considerable importance in recent years as it affects patient satisfaction and can adversely influence patient behavior (e.g., adherence to medical treatment), leading to a reduction in the quality of care. At the individual level, low level of job satisfaction and high level of job stress are threats to mental and physical health, quality of life, goal achievement and personal development. At the workplace, these conditions can lead to increased absenteeism, conflict and turnover; and reduced quality and quantity of work. Job satisfaction is also important to the future recruitment of new doctors and retention of the existing doctors, in addition to the productivity and quality of the services provided by the doctors, who are an essential and integral component of our medical care system¹.

A number of studies in the recent past have examined physicians’ career satisfaction. Research indicates that physicians who are satisfied with their careers are more likely to provide better health care and have more satisfied patients. Moreover, dissatisfaction among physicians in a particular specialization can lead to declining numbers of medical graduates of that specialty, an increase in rates of medical errors related to job stress, unionization, strikes, and even exodus from the medical profession².

Previous studies have proposed a number of determinants of job satisfaction, including demographic characteristics (age, gender, educational level, race, marital status), job characteristics (absolute and relative wages, number of hours worked, tenure, attitude towards work), and employer characteristics (number of staff, specialty, control over the practice environment and support from colleagues)³. Satisfaction level with different job characteristics has been studied in many developing countries such as Lithuania⁴, Saudi Arabia⁵ and Pakistan⁶ and these studies showed that respondents were most satisfied with autonomy at work, relationship with colleagues, and management quality. While the major factors of dissatisfaction among physicians included workload, unsuitable working hours and lack of incentives. In comparison, doctors working in developed countries, like UK and USA, face greater difficulty in gaining satisfaction from their work due to a complex array of factors including working environment conditions and socio-political factors.³A study conducted in Ireland in 2000, assessing pediatric hospital doctors, showed that the majority were no longer satisfied with their jobs mainly because of long hours, poor career prospects and dealing with very sick patients.⁷

Job satisfaction has been identified as an important determinant of employee retention, turnover and work performance. In health service, job satisfaction is highly associated with staff's intention to quit, quality and efficiency of services, and patient satisfaction. It has been reported that doctors with higher job satisfaction are more likely to provide more satisfactory services and produce better therapeutic effect than those with the lower one. Therefore, higher job satisfaction tends to result in much higher patient satisfaction and reduce medical costs, thereby making a hospital more competitive⁸.

2. Objectives

To determine levels and sources of job-related satisfaction among physicians. To identify some factors associated with satisfaction among physicians such as socio-demographic factors and nature of the job.

3. Methodology

A cross-sectional study was utilized in 2011 at the 3 main hospitals affiliated to Dubai Health Authority in Dubai (Rashid, Dubai, and Latifa hospitals). Five hundred and fifty questionnaires were distributed among all physicians in the three hospitals after obtaining the verbal consent. The sample size was 353 physicians out of 550 with 64.2% response rate. Out of 353 questionnaires returned, 282 were complete and eligible for analysis. Self-administered questionnaire was used. The questionnaire contains 4 sections; socio-demographic data, habits and life style, occupational data, and assessment of job satisfaction.

The total score of job satisfaction was divided into low, moderate and high according to scores below 50th percentile, above 50th to 75th percentile and equal to or above 75th percentile respectively. For total satisfaction score, low < 38, moderate 38 to < 46 and high ≥ 46.

4. Results

Table (1) showed that the total mean score of satisfaction is 37.75 and almost all domains of satisfaction has more or less similar means.

Table (1). Scores of total satisfaction and satisfaction factors among Dubai hospitals’ physicians.

Table (2) presents the mean total satisfaction score of physicians according to the socio-demographic characteristics. Physicians aging ≥ 50 years old, had significantly higher mean total satisfaction score (42.4 ± 9.1) than those aging > 40 - < 50 years old and ≤ 40 years old (37.3 ± 9.6 and 36.3 ± 11.7 respectively). As regard to gender of physicians, there was no statistical significant difference between mean total satisfaction score of females and males (37.5 ± 11.3 and 37.95 ± 10.7 respectively). There was also no statistical significant difference between the mean total satisfaction score of both UAE national physicians and non UAE nationals. However, UAE nationals scored higher than non UAE nationals (38.8 ± 9.4 and 37.5 ± 11.4 respectively). As regard to education level, physicians with PhD or equivalent degree had significantly higher mean total satisfaction score than those with bachelor degree (39.7 ± 10.6 and 35.04 ± 11.4 respectively).

Table (2). Mean total satisfaction score among Dubai hospitals’ physicians according to socio-demographic characteristics.

*P < 0.05 (significant)

Table (3). Mean total satisfaction score among Dubai hospitals’ physicians according to life style and habits.

*P < 0.05 (Significant)

Table (3) describes the mean total satisfaction score of physicians according to life style and habits. There was no statistical significant difference in mean total satisfaction score among physicians regarding smoking and drinking alcohol. Nevertheless, current smokers showed higher score than non smokers and ex smokers (40.9 ± 9.1, 37.7 ± 11.1 and 36.13 ± 10.2 respectively). In addition, non drinkers of alcohol were more satisfied than current and ex drinkers (37.9 ± 10.9, 33.00 ± 19.2 and 25.5 ± 3.5 respectively). On the other hand, physicians who were not physically active for at least 60 minutes per day during the last 7 days were significantly less satisfied (34.00 ± 9.4) than those physically active for 1-3 days or 4-7 days per week ( 39.7 ±10.8 and 37.9 ± 11.5 respectively).

Table (4) shows the mean total satisfaction score of physicians in hospitals according to occupational data. Physicians with surgical specialty were significantly more satisfied (40.2 ± 9.5) than those with non surgical one (36.9 ± 11.5). Moreover, consultants were also significantly more satisfied (41.5 ± 9.3) than juniors (specialists 38.2 ± 11.00, principle house officer 35.2 ± 6.5 and senior house officer 34.8 ± 11.6). Regarding total years of experience, physicians with longer years of experience were significantly more satisfied (≥ 20 years; 41.8 ± 8.7) than those with less years of experience (> 10 - < 20 years; 37.5 ± 11.6 and ≤ 10 years; 35.8 ± 11.00). On the other hand, there was no statistical significant difference in the mean total score of satisfaction of physicians according to number of working hours per week or number of night shifts per week. Nevertheless, those with less working hours per week (≤ 40 hours/week; 38.7 ± 11.2) were more satisfied than those working > 40 hours/week (37.5 ± 11).

Table (4). Mean total satisfaction score among Dubai hospitals’ physicians according to occupational data.

*P < 0.05 (Significant)

5. Discussions

The study brought out that satisfaction can be predicted by age. It was found that physicians aging ≥50 years, had significantly higher mean total satisfaction score (42.4 ± 9.1) than those aging > 40 - < 50 years (37.3 ± 9.6) and ≤ 40 years (36.3 ± 11.7).

The second predictor is physical activity. Physicians who were not physically active for at least 60 minutes per day during the last 7 days were significantly less satisfied (34.00 ± 9.4) than those physically active for 1-3 days or 4-7 days per week ( 39.7 ±10.8 and 37.9 ± 11.5 respectively).

Other predictors are specialty and experience. Physicians with surgical specialty were significantly more satisfied (40.2 ± 9.5) than those with non-surgical one (36.9 ± 11.5). Moreover, consultants were also significantly more satisfied (41.5 ± 9.3) than juniors (specialists 38.2 ± 11.00, principle house officer 35.2 ± 6.5 and senior house officer 34.8 ± 11.6). Regarding total years of experience, physicians with longer years of experience were significantly more satisfied (≥ 20 years; 41.8 ± 8.7) than those with less years of experience (> 10 - < 20 years; 37.5 ± 11.6 and ≤ 10 years; 35.8 ± 11.00).

On contrary, other factors were found significant in the international research. It has been argued strongly that good relationships amongst workers and members of work groups are essential for both individual and organizational health⁹. Low interpersonal support at work has been found to be associated with high anxiety, emotional exhaustion, job tension and low job satisfaction. Studies have found that mistrust of co-workers is related to high role ambiguity, poor communication, low job satisfaction, and poor psychological well-being⁹. In the current study, having good relationships with patients, relatives and staff was not a significant predictor of satisfaction among the studied physicians.

According to literature, in health care organization many factors are very essential: optimal work arrangement; the possibility to participate actively in decision making process; effective communication among staff and supervisors and to be able to express freely one’s opinion¹⁰. In this study, having high level of autonomy and being able to bring positive change in unit/institution were items under the satisfaction factor of having professional status/esteem. The factor was not a significant predictor of total satisfaction score.

In all of the doctor groups in a study about Physician job satisfaction in New Zealand versus the United Kingdom, significant numbers of doctors had often contemplated leaving the medical profession¹¹.

In addition to nationality it was found that overload disruption to home life, feeling poorly managed and resourced and dealing with patients’ suffering were significant predictors of total satisfaction score among physicians¹².

6. Conclusion

Physicians with PhD or equivalent degree and older ages (≥ 50 years old) were more satisfied. In addition, physicians with longer years of experience were significantly were more satisfied. Specialty and physical activity (exercise) were significant predictors of total satisfaction score. Moving to another hospital, changing job, having health problems, quitting job and having poor relationships with coworkers were all reported as consequences of job dis satisfaction by the physicians.

Recommendation

Aspects of job related factors associated with job dissatisfaction among physicians surgical specialty should be addressed including the impact on personal and family life. Periodic health appraisal including mental health assessment should be carried out for the physicians and other health care workers. To reduce job dis satisfaction of physicians, measures should be undertaken to improve the structural conditions within the departments and involve the physicians in stress reliving activities.

References

1. Kaur S, Sharma R, Talwar R, Verma A, Singh S. A Study of Job Satisfaction and Work Environment Perception among Doctors in a Tertiary Hospital in Delhi. Indian J Med Sci, 2009; 63 (4).
2. Deshpande SP, DeMello J. An Empirical Investigation of Factors Influencing Career Satisfaction of Primary Care Physicians. JABFM November–December 2010; 23 (6).
3. Grant P. Physician job satisfaction in New Zealand versus the United Kingdom. N Z Med J. 2004; 117(1204): U1123.
4. Buciuniene I, Blazeviciene A, Bliudziute E. Health care reform and job satisfaction of primary health care physicians in Lithuania. BMC Fam Pract. 2005; 6(10): 1-6.
5. Kalantan KA, AL-Taweel AA, Abdul Ghani H. Factors influencing job satisfaction among primary health care (PHC) physicians in Riyadh, Saudi Arabia. Ann Saud Med. 1999; 19(5): 424-6.
6. Khuwaja AK, Qureshi R, Andrades M, Fatmi Z, Khuwaja NK. Comparison of job satisfaction and stress among male and female doctors in teaching hospitals of Karachi. J Ayub Med Coll Abbottabad. 2004; 16 (1): 23-7.
7. Thomas L, Valli A. Levels of occupational stress in doctors working in a South African public-sector hospital. SAMJ 2006; 96 (11).
8. Liu J, Wang Q, Lu Z. Job satisfaction and its modeling among township health center employees: a quantitative study in poor rural China. BMC Health Services Research 2010, 10:115 http://www.biomedcentral.com/1472-6963/10/115.
9. Leka S, Jain A. Health Impact of Psychosocial Hazards at Work: An Overview. Institute of Work, Health & Organisations, University of Nottingham. WHO 2010.
10. Kaarna M. The importance of job satisfaction in hospital quality process. Nordic School of Public Health 2007. http://www.nhv.se/upload/dokument/forskning/Publikationer/MPH/2007/MPH2007-4_Marina_Kaarna.pdf.
11. Williams ES, Konrad TR, Scheckler WE, et al. Understanding physicians' intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. Health Care Manage Rev. 2001; 26:7–19.
12. Leontaridi R, Ward M. Work-Related Stress, Quitting Intentions and Absenteeism. Institute for the Study of Labor 2002. http://ftp.iza.org/dp493.pdf.