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Research Article
 

Analysis of the Need of Flexibility in Working Lives of Orthopaedy, Physiotheraphy and Rehabilitation Doctors Who Work in Universities’ Research Hospitals and Private Hospitals



Murat Korkmaz, Bulent Kilic, M. Talas and Ali Serdar Yucel
 
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ABSTRACT

In today’s globalization conditions, the competitiveness of health sector is more prominent. Therefore, the physicians who actively participate in health sector have gained significant importance in terms of competition. This study examined the adaptation of orthopedists, physical therapists and rehabilitation specialists who are employed within the health sector to the working life. A total of 748 physicians from “Orthopedics, Physiotherapy and Rehabilitation” participated in the study. Cities of Istanbul, Ankara, Tekirdag, Bursa and Izmir constitute the target population of the study. A total of 58 public and private medical institutions were included. This number is the sample of the study. The study is an applied one and a questionnaire was used in the research. Reliability analysis was obtained following the general research and a coefficient of 0.963 was found after Cronbach Alpha. In addition to data obtained from the research, frequency tables, descriptive statistics, independent t test, Pearson correlation analysis, one-way variance analysis and Tukey test were utilized in the practice. It has been concluded following the research that the flextime provided to orthopedists, physical therapists and rehabilitation specialists working in training research, university and private hospitals increases the quality of life and accordingly effectiveness and performance level improves.

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  How to cite this article:

Murat Korkmaz, Bulent Kilic, M. Talas and Ali Serdar Yucel, 2015. Analysis of the Need of Flexibility in Working Lives of Orthopaedy, Physiotheraphy and Rehabilitation Doctors Who Work in Universities’ Research Hospitals and Private Hospitals. Journal of Applied Sciences, 15: 120-128.

DOI: 10.3923/jas.2015.120.128

URL: https://scialert.net/abstract/?doi=jas.2015.120.128
 
Received: July 24, 2014; Accepted: October 13, 2014; Published: November 20, 2014



INTRODUCTION

One of the results of globalization that has left its mark on our age and accompanying fierce international competition is the necessity to make working life flexible in line with the changing conditions. The concept of globalization and fierce international competition spreading very fast together with the technological developments have brought the concept of flexibility into question by deeply affecting working life (Turan, 2005).

Flexibility as a concept, means the ability to adapt the changes and differences (Arslanoglu, 2005). When the concept of flexibility is discussed in terms of working life, it is seen that it is requested to be told with different expressions. As a matter of fact, flexibility is attempted to be told with such different expressions as labor market flexibility, labor flexibility, flexible working and deregulation (Turan, 2005).

The definition of flexibility with the most common meaning can be as; “using the necessary tools in order to be able to arrange the capacity against the unpredictable changes and to reach this purpose” (Tatlioglu, 2012).

Flexibility points out to the different structures affecting various fields and being affected by particularly scientific and technological developments and it has no strict structure (Noyan, 2007).

In general terms, the concept of working is stated as “a purpose-oriented and continuous social activity in which an individual produces valuable goods and services for herself/himself or for others in return for a material and spiritual gain by consuming physical, mental or spiritual energy” (Kapiz, 2001). The first thing that comes in mind when speaking of flexibility in working life is the ability to answer and adapt to change (Rodgers, 2007; Filiz, 2011). In other words, flexibility in working life can be expressed as the system which allows working conditions to be arranged in a way to be able to meet several needs (Arslanoglu, 2005). It is possible to ensure an employment type in which the employee can allocate more time for her/his own social life thanks to flexible working (Oguz, 2007). Employees will have more right to speak in determining their own working hours by changing into flexible working system from normal working system and accordingly they will be able to manage their private life more positively (Kayalar, 1997).

Flextime is considered important in terms of the needs of employees. Employees feel the need for flexible working ways in order to organize their time better, to work in more than one workplace on the same day or due to the reasons arising from the nature of work (Noyan, 2007). Another benefit of flexible working for employees is that it helps them to balance between working life and family life. Flexible working is more desirable for women who feel the highest pressure on themselves and have the difficulty in balancing between private life and work (Filiz, 2011). Apart from that, employees can spare their time for their social relations and private affairs more easily thanks to flexible working (Kucuk, 2004; Karlidag, 2011).

The concept of flexibility is mentioned in significant discussions today in terms of its scope, function and effects. While flexibility practiced in working life is expressed as a tool which increases employment and social welfare on the one hand, it is also regarded as a practice which harms labor markets, organization, rights and rules on the other hand (Zengingonul, 2003; Koray, 2005).

Flexible working types are a real matter of fact and they are becoming widespread day by day. Flexible working is different from classic/traditional working order. In other words, it means establishing an open and free system which allows working conditions to be arranged in different ways according to the needs within the legal framework for employees, instead of working with the rules determined under protection and arrangement of law (Ekonomi, 1994). There are non-standard working ways and times in this system. Employee can determine the working order with employer mutually as different from being standard (Eryigit, 2000).

Consequently, an alternative way of working is provided for the ones who have adaptation problems for working life and unable to work with normal way (Cakir, 2001). Flexibility and work, “Workplace and shift” are redefined. After the elimination of precise limits for place and time, a number of freedoms are given to employees and their motivation is considerably increased (Ekonomi, 1994).

Such practices as part-time working and flexible working do not generally yield the same rights with full-time working and for this reason it is evaluated negatively. However, such kind of working ways can be the ones not only demanded by enterprises but also by employees which meet their demands. It is increasingly regarded as more important and necessary in creating consistent conditions between work and home for women particularly and between work and study for young people (Koray, 2005).

Today, flexible working ways are changing into common practices gradually. Within this framework, the need to make current labor laws flexible both in developed and developing countries is arising (Filiz, 2011). The subject that is a matter of interest for many occupations has gained importance also for physicians who is a part of health sector in which competition has come into prominence.

The fact that the physicians working in Turkey have other duties and responsibilities like scientific research, training, administrative and academic studies in addition to such health services as examining patients and/or performing surgery leads to a heavy and risky image of working conditions. Due to the work load which is increasing with the inadequate equipment and small number of health personnel and long working hours, low wages push the physicians into job dissatisfaction and low motivation (Kumas and Yucel, 2007). As working hours, working conditions and norms will be determined as based on the needs of employees with flexible working practices, an employee will start working at the most appropriate time for herself/himself and so he/she will have the right to speak concerning her/his own time and this will create positive effects on motivation. Moreover, such reasons as coming to work late, incomplete work, allocating more time to social activities and private matters which will affect the employee’s motivation can be eliminated with flexible working (Kayalar, 1997).

Turkey has also been affected from the economic and social change experienced at international scale. This change that also affects labor market has resulted in proliferation of flexible working types. Due to the effect of being in EU accession process, the types of flexible working have taken place in laws that regulate working life (Celik, 2007). However, there are also disadvantages of flexible working in addition to its advantages for employees. Due to the fact that flexible working can’t provide adequate legal protection by its nature, it negatively affects job security and employees working flexible are legally less protected than the full-time workers. For this reason, non-standard employment types without enough job security are the less-secured working ways by their characteristics (Filiz, 2011). As in many other fields, flexible working practices have become a subject that is also frequently a part of health sector in which competition has come into prominence.

It is observed that although there are some physicians thinking that flexible working system in health sector bears a necessity and even obligation for Turkey, there are also some others having the opinion that the physician will be regarded as temporary staff and the belonging of the physician for the clinic where he/she works will be destroyed. So there isn’t a consensus regarding this matter. In this regard, the main purpose of the study is to determine the need for flexible working felt by orthopedists, physical therapists and rehabilitation specialists working in private hospitals.

It can be uttered that this study in which the opinions of orthopedists, physical therapists and rehabilitation specialists working in private hospitals regarding this matter are discussed will shed light on the subject.

MATERIALS AND METHODS

The target population is Turkey and cities of Istanbul, Ankara, Izmir, Bursa, Tekirdag, Elazig, Nigde and Samsun constitute the sample. A questionnaire was applied to a total of 748 people working in 56 public and private hospitals and survey questions were composed of demographic characteristics and flexibility in private hospitals. There are 5 Likert scaled 32 questions and 7 demographic questions in the questionnaire used. The questionnaire applied was not previously used, it was inspired from the questionnaire used in the thesis titled as “Flexibility in Working Life-An Applied Study” from the Institute of Social Sciences in Beykent University by Karlidag (2011). The previously used questions were adapted for the current research and before the main research a preliminary practice was carried out regarding the opinions of a total of 85 orthopedists, physical therapists and rehabilitation specialists in the target city of Istanbul and sample districts of Bakirkoy, Bahcelievler and Fatih. All of the physicians who participated in the main research were randomly selected. The questionnaires were delivered to those physicians via mail and by hand. Following the preliminary test, the results of reliability analysis were interpreted by taking into account a Cronbach alpha coefficient and the one which is found after excluding from the analysis for each variable. Following the preliminary reliability and validity analysis, the coefficient was found 0.879. Reliability analysis was obtained following the general research and a coefficient of 0.963 following Cronbach’ alpha.

Descriptive statistics, reliability analysis, Pearson correlation analysis, independent t-test, variance analysis and Tukey test were utilized within the analysis.

Statistical analysis: Data obtained following the questionnaire was analyzed by PASW 18.0 package program. Within the scope of analysis, descriptive statistics, reliability analysis, Pearson correlation analysis, independent t-test, variance analysis and Tukey test were carried out.

RESULTS

Demographic statistics: The 69% of the participants were female and 31% of them were male. About 61% were married, 39% were single. 65% of the participants were aged between 20 and 30, 34% of them were aged between 31 and 40 and 1% were aged between 41 and 50 (Table 1).

Regarding the educational status of the participants; it was observed that 22% were assistant, 25% were assistant professor, 30% were expert, 6% were associate professor and 17% were professor. Regarding their positions in the institution; chiefs have a share of 19%, mid-level managers have 47%, senior managers have 34%. The 1-5 years of professional experience have a share of 22%, 6-10 years have 25%, 11-15 years have 30%, 16-20 years have 6% and 21 years and more have a share of 17%. Income level in the amount of 1000-2000 has a share of 5%, 2000-3000 has 61%, 3000-4000 has 20%, 4000-5000 has 2% and 5000-6000 has a share of 12% (Table 2).

Reliability analysis: Due to the fact that Alpha = 0.963 following the reliability analysis, it can be said that 78 items were at a very high reliability level (Table 3).

Need for flexibility in private hospitals correlation analysis: The items related to the need for flexibility in private hospitals were analyzed with correlation analysis and the relations between the items are stated below (Table 4).

A strong and positive relation exists between the statements “Decreasing labor cost” and “fast adaptation to the changing environmental conditions” (r: 0.742; Sig: 0.000). The relation is statistically significant.

Table 1:Demographic variables of the participants (sex, marital status, age)

Table 2:Demographic variables of the participants (education, position, experience, income)

Table 3: Reliability analysis for the scale

Table 4: Correlation analysis regarding the need for flexibility in private hospitals

A strong and positive relation exists between the statements “Decreasing labor cost” and “decreasing the liabilities resulting from Labor Law” (r: 0.652; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Decreasing labor cost” and “protection of competitive power” (r: 0.698; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Decreasing labor cost” and “increasing labor productivity” (r: 0.534; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Decreasing labor cost” and “providing convenience in finding qualified personnel” (r: 0.525; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Fast adaptation to the changing environmental conditions” and “Decreasing the liabilities resulting from Labor Law” (r: 0.870; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Fast adaptation to the changing environmental conditions” and “Protection of competitive power” (r: 0.786; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Fast adaptation to the changing environmental conditions” and “Increasing labor productivity” (r: 0.571; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Fast adaptation to the changing environmental conditions” and “Providing convenience in finding qualified personnel” (r: 0.830; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Decreasing the liabilities resulting from Labor Law” and “Protection of competitive power” (r: 0.853; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Decreasing the liabilities resulting from Labor Law” and “Increasing labor productivity” (r: 0.678; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Decreasing the liabilities resulting from Labor Law” and “Providing convenience in finding qualified personnel” (r: 0.796; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Protection of competitive power” and “increasing labor productivity” (r: 0.844; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Protection of competitive power” and “Providing convenience in finding qualified personnel” (r: 0.679; Sig: 0.000). The relation is statistically significant.

A strong and positive relation exists between the statements “Increasing labor productivity” and “Providing convenience in finding qualified personnel” (r: 0.534; Sig: 0.000). The relation is statistically significant.

H0: The items related to flexibility don’t differ by sex

When significant values were examined, it was determined that significant values of all factors are smaller than 0.05 and H0 hypotheses should be rejected accordingly. Therefore the related item differs by sex (Table 5).

H0: The item related to flexibility doesn’t differ by marital status

When significant values were examined, it was determined that significant values of all factors are smaller than 0.05 and H0 hypotheses should be rejected accordingly. Therefore, the related item differs by marital status (Table 6).

H0: The item related to flexibility doesn’t differ by age

When significant values were examined, it was determined that significant values of all factors are smaller than 0.05 and H0 hypotheses should be rejected accordingly. Therefore, the related item differs by age (Table 7).

H0: The item related to flexibility doesn’t differ by education

When significant values were examined, it was determined that significant values of all factors are smaller than 0.05 and H0 hypotheses should be rejected accordingly. Therefore the related item differs by education (Table 8).

Table 5:Independent sample t-test analysis of factors about flexibility by sex

Table 6:Independent sample t-test analysis of factors about flexibility by marital status

Table 7:ANOVA analysis of factors about flexibility by age

Table 8:ANOVA analysis of factors about flexibility by educatio

Table 9:ANOVA analysis of factors about flexibility by the position in the institution

Table 10:Distribution of answers regarding the scaled questions

H0: The item related to flexibility doesn’t differ by the position in the institution

When significant values were examined, it was determined that significant values of all factors are smaller than 0.05 and H0 hypotheses should be rejected accordingly. Therefore, the related item differs by the position in the institution (Table 9). Scale questions are presented in Table 10.

DISCUSSION

The results of reliability analysis show that the study is 96% reliable and the results will bear resemblance in case the analysis is repeated.

Concerning the demographic distribution of the participants, it has been ascertained that the majority were females, married and aged between 20 and 30, mostly specialists and works as mid-level manager in the institution, has 11-15 years of experience and has an income that amounts to 2000-3000 lira.

About 82% of female employees were physical therapists and rehabilitation specialists, 12% were physician assistant.

With the participation of women labours, the labours who want side jobs and students into the labour market, flexible working schedules are more needed (Karlidag, 2011). In our country, the Labour Law No. 4857 of 22nd May 2003, in this sense, includes specific regulations that will form a legal basis for some flexible working practices (Sen, 2004).

In Holland, certain steps are taken for the development of part time working. For supporting this, Dutch Government developed specific social projects and put them into action. Dutch Government also worked through the participation of women labours and encouraged part time working (TISK, 2001).

Thanks to flexible working schedules, women took part in business world and they provided employment especially in fields like finance, banking, health, textile, service etc. And, restriction of women into the domestic sphere was abolished (Yavuz, 1995).

According to 2011 Global Social Gender Gap Report, in all member countries of Organisation for Economic Co-operation and Development, part time employment incidence is higher among women compared to men. From 2000-2011 while the rate of women’s participation in part time employment was decreasing in Sweden, Norway and Germany, this rate was increasing in Belgium, Italy, Poland and Turkey. In Turkey while one out of four working women is working in part time jobs; among men, this rate is under 10% (OECD, 2012).

In our country, like all around the world, health sector is a sector where women labour is dense. The experienced transformation made women medical staff’s working life harder with changes such as extended working hours, gradually decreasing job security, blurring job descriptions and performance measures (Ozturk and Ergunes, 2011).

According to Turkish Employment Agency’s 2007 reports, when cease of employment reasons are analysed, it is observed that while 20% of the employees leave their jobs because they are fired by their employers, 70% of the employees leave their jobs because of childbirth and their children (Ozturk and Ergunes, 2011). It can be said that such a result proves the importance of flexible working schedules for women.

When we look at the types of flexible working, flexible works such as part time working, teleworking and telecommuting help women to take more part in business life. Like employers, governments should also support flexible working types which help women to balance their responsibilities in domestic, family and business life (Karlidag, 2011).

In our country, when it is observed from the doctors’ point of view, as one of the biggest problems of workingwomen, women who take responsibility of children and domestic life prefer professions that will not prevent them from performing their gender roles in their houses. The number of women in surgical field is less than the number of women in basic medical field (Nalbantoglu, 2011). And, it proves how important the flexible working schedules are.

For employees, another benefit of flexible working schedules is that they help employees to balance between their family lives and business lives. Flexible working schedules become more and more attractive for women who have difficulty and feel the most pressure in balancing their private lives and business lives (Filiz, 2011).

In this study, it was determined that female medical doctors have more flexible working processes compared to male medical doctors. Additionally, it is determined that women employees are more flexible compared to male medical doctors and their performance levels and productivity levels are higher than male medical doctors. It can be stated that balancing private life and business life can be effective on performance and productivity.

We frequently encounter (Gurkanlar, 2010) with publications about that for women employees, flexible working systems will prevent or decrease the clash between work and family and help women to balance between these two (Friedman et al., 2001) and as a result of individual’s satisfaction with his/her family and social environment (Uyguc et al., 1998), his/her satisfaction with his/her job and life and his/her loyalty to the organization will increase (Kirel, 1999; Uyguc and Cimrin, 2004) and this will reflect credit upon his/her working performance (Friedman et al., 2001; Bayram, 2005).

Family’s disruptive effect on work is observed when gender roles’ responsibilities in families prevent job performances. For example, situations such as children’s illnesses or childcare, or school problems are family’s disruptive effect on work. Work’s disruptive effect on family, on the other hand, is observed when job responsibilities prevent responsibilities in family. For example, long working hours can prevent performing the responsibilities in family (Kinnunen and Mauno, 1998).

As a result of the research conducted between 2006-2008 by Cranfield School of Management and Working Families, among 3580 employees of Centrica, Citi, KPMG, Lehman Brothers, Microsoft, Pfizer and Rolls Royce companies via questionnaires, meetings and focus group discussions, it is proved that there is a negative relationship between flexible working and stress levels and there is a positive relationship between loyalty to the organization, job satisfaction and performance. Flexible working employees’ job satisfaction, loyalty to the organization and performances are observed to be significantly high (Kelliher and Anderson, 2008).

In this study, it is observed that workload and flexibility level of orthopaedists are less compared to women employees; their performance and productivity levels are less depending upon their workload. We can state that flexible working hours reduce women’s burden in work and family; it positively motivates them and it affects performances.

It has been found that female working physicians have more flexible working than male working physicians. It has been established that female working physicians have more flexibility than male working physicians and their performance level and effectiveness are higher.

It is seen that workload and flexibility level of orthopedists are lower than female workers, their performance and effectiveness levels are less as depending on workload.

It is observed that the level of flexible working is considerably low in orthopedists due to surgical intervention, high number of patients, workload and administrative problems.

When the breakdown of flexibility-related factors by demographic variables are analyzed, it is determined that these factors differ by Sex, Marital status, Age, Education, Position in the institution.

According to the correlation analysis results, the analysis of labor cost was found to be highly related to the items of adaptation to environmental conditions, decreasing the liability resulting from labor law, protection of competitive power, productivity and finding qualified personnel.

Adaptation to changing environmental conditions was found to be highly related to decreasing the liability resulting from labor law, protection of competitive power, productivity and finding qualified personnel.

Decreasing the liability resulting from labor law was found to be highly related to protection of competitive power, productivity and finding qualified personnel.

Competition was found to be highly related to the items of productivity and finding qualified personnel.

It is seen that physical therapists and rehabilitation specialists are in competition more than orthopedists and orthopedists develop more in surgery and their innovative characteristics on level of using technology stand out.

Productivity was found to be highly related to the item of convenience in finding qualified personnel.

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