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Journal of the Academy of Hospital Administration

The Role of Non-Financial Incentives in Motivating Doctors of a Teaching Hospital

Author(s): K. Vijaya*, E. Ravi Kiran

Vol. 14, No. 1 (2002-01 - 2002-06)

Key Messages:

  • Job environment has been identified as the highest motivating non-financial incentives among doctors working in all the pre, para and clinical departments.
  • Appraisal has been identified as the least motivating non-financial incentive.
  • Identifying and addressing the motivational needs of doctors is of paramount importance in a teaching hospital.

Abstract

Today the most important question confronting any manager or a hospital administrator is, "How do you get employees to work to achieve organizational goals?".

The key to realisation of these goals lies in motivation of the employees through incentives. Monetary or financial incentives are not important to some employees. For most of the work force, lower needs like safety and physiological needs are substantially satisfied and they concentrate on higher order needs like status, esteem and self actualization as in Maslow's model.

It is very essential for the hospital administrator to have the knowledge and relation of the different motivating factors influencing employee's behaviour in order to understand the work attitude of each employee. Thus he or she can learn to deal with employees differently according to the strongest and dominant motivational drive in each of them. The present research paper identifies and discusses the role played by various non-financial incentives in motivating doctors of a teaching hospital which is very important as it not only serves the community but also acts as an embodiment of knowledge and furthering research in medicine to students as well as budding doctors.

Keywords: Motivation, Non-Financial Incentives

Introduction

It is widely recognized nowadays that the human element in an organization cannot be underestimated. In contrast to the old management styles, present managers understand the importance of the contributions of the employees working under them and try to maximize these contributions. In a service oriented organisation like a hospital, if the employees are not properly motivated, cannot give efficient patient care and effective quality services; thus compromising the good will of the hospital. So it is absolutely essential that the employees in a hospital must be motivated by providing proper incentives.

Goel states that among the three components required for developmental tasks men, money and material it is more the men duly qualified than any other factor which determined the quantity and quality of output. After all the contribution of money and material to performance depends on their manipulation by the men in the organization1.

Chandan states that intrinsic motivation stems from feelings of achievement and accomplishment and is concerned with the state of self actualization in which the satisfaction of achieving something worthwhile motivates the employees further so that motivation is self generated and is independent of financial rewards. Some of the intrinsic motivators are praise, recognition, responsibility, esteem, power, status, challenges and decision-making responsibilities2.

Davar states that whilst money is an important motivator of human behaviour in terms of the need hierarchy it can help satisfy only the physiological needs of the human beings. This brings into focus the importance of non-financial incentives or psychic wages aimed at satisfying the other needs in the hierarchy. As one moves up the employee hierarchy or the management hierarchy the needs higher up in the Maslow's need hierarchy come into operation3.

Magnes is of the opinion that health management organisation's use of non-financial incentives appears to be intensifying in parallel with their use of financial incentives. Researchers maintain that intrinsic rewards such as self worth and self determination are more powerful than extrinsic rewards like bonuses4.

The doctors in a teaching hospital perform the dual role as a teacher and also a medical professional. It is essential to identify "felt needs" of doctors and its strength, for skillful use of management tools for improving motivational level5.

Motivating workers in hospitals requires organization to provide opportunities as well as resources for satisfaction of professional needs6.

Materials and methods

This descriptive study was carried out in one of the teaching hospitals in Mangalore city by using simple random sampling technique. A sample of 32 doctors was selected out of a population of 70 doctors working for the teaching hospital. The period of study was 3 months, from September to November 2001. A structured questionnaire on the demographic data and 9 non-financial incentives was given to the selected sample. The 9 non-financial incentives that were assessed were delegation of authority, participation, job environment, job security, growth and development, competition, job enrichment, recognition and appraisal. The scoring of responses was done on a 5 point Likert Scale.

The distribution of the non financial incentives effecting motivation was analysed in terms of frequency of degrees of motivation and the mean motivation score of each factor.

Total factor score from the samples

Mean motivation score = _________________________________

No. of questions x sample size related to each factor

By using the above formula for each factor the mean motivation score lies in between 1 and 5. If it is<3 it is taken as low, equal to 3 as moderate and >3 as high motivating score of a factor. Ranking of the influence of each non financial incentives on motivation was done on basis of mean motivation score.

Table - I: Influence of Non-Financial Incentives on Motivation in Preclinical Departments

Sl.
No.
Non Financial incentives Degree of motivation Mean
Motivation
score
Mean % Rank
Low
(<3)
Medium
(=3)
High
(>3)
1. Delegation 0 0 4 3.54 70.8 III
2. Participation 0 0 4 3.7 74.0 II
3. Job environment 0 0 4 4.1 82.0 I
4. Job security 2 0 2 3.5 70.0 IV
5. Growth/development 2 1 1 3.2 64.0 V
6. Competition 2 1 1 3.0 60.0 VI
7. Job enrichment 0 1 3 3.5 70.0 IV
8. Status/recognition 2 0 2 3.5 70.0 IV
9. Appraisal 2 1 1 3.0 60.0 VI

The highest motivating non financial incentive is job environment, with the mean motivation score of 4.1 among the doctors of preclinical departments. The other highly motivating non financial incentives are participation, delegation of authority and job enrichment.

Table - II: Influence of non financial incentives on motivation in para clinical departments

Sl.
No.
Non Financial incentives Degree of motivation Mean
Motivation
score
Mean % Rank
Low
(<3)
Medium
(=3)
High
(>3)
1. Delegation 0 0 10 3.71 74.2 V
2. Participation 1 0     76.6 III
3. Job environment 3 0 15 4.12 82.4 I
4. Job security 1 5 12 3.86 77.2 II
5. Growth/development 3 3 12 3.41 68.2 VI
6. Competition 3 7 8 3.33 66.6 VII
7. Job enrichment 7 0 11 3.29 65.8 VIII
8. Status/recognition 2 2 14 3.74 74.8 IV
9. Appraisal 5 4 9 3.13 62.6 IX

The highest motivating non financial incentive is job environment, with the mean motivation score of 4.12 among the doctors working in clinical departments. The other highly motivating non financial incentives identified are job security, participation and status.

Table - VII: Influence of non financial incentives in all (pre, para and clinical) clinical departments

Sl.
No.
Non Financial incentives Degree of motivation Mean
Motivation
score
Mean % Rank
Low
(<3)
Medium
(=3)
High
(>3)
1. Delegation of authority 1 0 17 3.66 73.2 V
2. Participation 2 1 15 3.83 76.6 III
3. Job environment 3 0 15 4.12 82.4 I
4. Job security 1 5 12 3.86 77.2 II
5. Growth/development 3 3 12 3.41 68.2 VI
6. Competition 3 7 8      
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