Job Security, Organizational Support and Employee Performance: Mediating role of Employee Satisfaction in Medical Sector of Pakistan

Abstract

The study seeks systemic identification of job security, organizational support and employee satisfaction and investigated impact on employee performance in medical sector of Pakistan .The unit of analysis is an individual medical doctor. Cross sectional survey design has been used for data collection and distribution of instrument as distribution of questionnaire. The random sampling technique is used to conduct the study. The analysis was conducted through SPSS software. The job security and organizational support are independent variables, employee satisfaction is the mediator and employee performance is dependent variable. The study found significant positive relation between job security and employee satisfaction. The study also found positive relation of organization support and satisfaction of employees at medical sectors. If organization supports medical doctors for (their job structure), security and payment policies will be influential towards better performance of employees. The mediating relationship was also found to be significant , study found significant positive relation and mediation effect of employee satisfaction between job security , organization support and employee performance. Introduction & Background Performance is considered as essential element in managing organizations worldwide where outcomes are compared with overall organizational goals and objectives. Organizations have to focus extensively on performance of employees to enhance their capabilities and for achievement of goals. Therefore, performance of doctors in hospitals emerges as an important factor in medical field due to its sensitivity. Due to sensitivity of medical profession as it is physically and psychologically involvement intensive job as it requires long working hours, facing difficult situations, sensitive and heavy process of medical roles. According to (Balch, Freischlag, & Shanafelt, 2009) stated that doctors International Journal of Academic Research in Business and Social Sciences Vol. 9 , No. 3, March, 2019, E-ISSN: 2222-6990 © 2019 HRMARS 1252 keep their personal issues and harms distinctively away from professional life in order to update their professional life. Basically, medical doctors play vital role in assisting patients in exchange of responsibilities for increasing life expectations and well-being of society. Therefore, performance of medical doctors needed to be managed and sustain and becomes critical in influencing the health and life expectancy of patients (Royal college of physicians, 2005). Medical doctors in Pakistan considered as a noble profession due to the nature and sensitivity as it directly influence health and life of people in society. Researchers have stated various performance related issues of medical doctors in Pakistan as insufficient in performing duties caused by frustration which ultimately influence them to quit their job or leave the country for better options. The medical doctors performing their duties in public sector hospitals usually found to be early leaving their premises. This depict irresponsible behavior of doctors which causes various serious issues including neglecting the patients. Khan, Ahmad, Aleem, and Hamed (2011) raised the issues of behavioral problems of doctors at their workplace. Various factors found to be contributive towards detrimental and negative behavior of medical doctors which includes job insecurity, organizational support (supervisors & colleagues), nature of job, remuneration and incentives, satisfaction with their job and duties and performance of employees (Okpara, 2004). The under discussion variables are widely researched in various other business and management fields, but limited literature is available related to medical doctors in Pakistan. Organizational support found to be influential on performance positively, organizational support relates to the health of employees and recognize the efforts of employees at workplace. Organizational justice, support of colleagues & coworkers, rewards, working conditions, promotions, job security and empowerment found to be as influential antecedents of performance of employees at workplace According to Kazmi (2011) medical doctors found to be dissatisfied with policies developed, value given to medical doctors, promotional structure, remuneration and other factors which instigate and influence job performance. Medical doctors found to be dissatisfied and disappointed which effect negatively to their performance, the various factors including status, stress, description of their duties and load, personal issues and problems found to be influential on their poor performance (Ghazali, Shah, Zaidi, & Tahir, 2007). Various other problems have been reported due to unplanned health services and care which include medical doctors and nurses’ ratio, further, Lack of trained doctors, shift of doctors from villages to urban territories and out of country according to Health Issues in Pakistan, (2012) further it was reported in M. Khan (2015). Service structure of medical doctors is poorly defined stated as one of major hurdle and problem in Pakistan as it doesn’t offer any attractive rewards in return of performance and technical issues are ignored overtime. In respond to these issues medical doctors involve in detrimental behavior and negative emotions and ignore to join duties in public sector hospitals. They join their duties after marking their attendance and leave premises early, further they remain deviant at workplace in response to emergency. Moreover, the attitude of doctors towards rich and poor patients is different and it negatively impact performance of doctors in public sector hospitals (Health Issues in Pakistan, 2012). International Journal of Academic Research in Business and Social Sciences Vol. 9 , No. 3, March, 2019, E-ISSN: 2222-6990 © 2019 HRMARS 1253 Problem Statement The job security and organizational support influence on the work related outcomes. Organizations have to focus extensively on performance of employees to enhance their capabilities and for achievement of goals (Chen, 2017). Therefore, performance of doctors in hospitals emerges as an important factor in medical field due to its sensitivity. Ghazali et al. (2007) and Khan et al., (2011) reported previously that doctors in all provinces of Pakistan found to be unhappy with their jobs and due to problems in their service structure they have called for strike and stopped working in public sectors hospitals. The policies developed for doctors doesn’t reflect their security of job, promotion procedure and remuneration planning which instigated them to initiate strike call and it negatively affect the performance. Further, Khan (2014) also reported negative and problems in associated with doctors’ performance and linked it with low salary as $ 200/month to provide services in public sector hospitals. The less salary and remuneration packages medical doctors in Pakistan get into dissatisfaction and calls for strikes to compel government to develop better policies, due to these strikes health and life of patients are on risk. Disturbing figures have been reported in relation to increased death rates since 2011 and recently due to strikes almost 500 patients died (Pakistan Health care system, 2018). These strikes were due to promotion policies, remuneration restructuring and job security of medical doctors to satisfy their needs. Previously, various studies explain multiple reasons of dropped performance such as insecurity of job and studies found positively negative influence of job insecurity on performance (Khan, 2015; Morris, Lydka, & O Creevy, 1993). Various other studies conducted research on factors including job insecurity, low salary and remuneration packages, promotion structure issues, absence of autonomy at job, working situations and nature of job significant negatively impact performance of employees. The limited researches are available on the performance of medical doctors of public hospitals in Pakistan and empirical examination is scanty (Khan et al., 2015). Previously various factors have been examined in literature in relation to performance of medical doctors in Pakistan. Hence, current study intends to examine the mediating role of job satisfaction of doctors while considering the relation between job security and support of organization. Social exchange theory posits that workplace and environmental behavior found to be influential for understanding the phenomenon. The rule of reciprocity claims that perception of employees about their workplace environment, which says if managers are found to be supportive towards employees, secure their employees and appropriate reward; in return employees will be satisfied as reciprocate. It is critically important to investigate performance of doctors’ in Pakistani context and related factors. So the current study intend to examine organizational support and reward strategy (financial & non-financial) towards satisfaction, further which leads towards job performance of medical doctors. Objectives The objectives of the study are threefold. Which includes following: 1) To examine the contribution of organizational support to satisfaction of medical doctors. 2) To examine the influence of job security to satisfaction of medical doctors. 3) To identify the mediating role of satisfaction of doctors and its influence on performance at public sector hospital. International Journal of Academic Research in Business and Social Sciences Vol. 9 , No. 3, March, 2019, E-ISSN: 2222-6990 © 2019 HRMARS 1254 Literature Review Employees perform their duties to meet the goals and objectives of organizations and work related activities compared with allocated tasks are referred as job performance. Researchers and scholars (Bernardin & Beatty, 1984; Khan, 2015) stated performance of employees can be examined as outcomes and results of performed tasks. Scholar Bright (2007) stated that b