'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa

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dc.contributor.authorAshmore, Johnen_ZA
dc.date.accessioned2015-11-23T11:42:20Z
dc.date.available2015-11-23T11:42:20Z
dc.date.issued2013en_ZA
dc.description.abstractBACKGROUND: There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the public sector. METHODS: Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist 'dual practice', that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. RESULTS: Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel 'needed' and 'relevant'. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. CONCLUSIONS: The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the public sector. Policy recommendations center around boosting public sector resources and building trust of the public sector through including health workers more in decision-making, inter alia. These interventions may be more cost-effective for retention than wage increases, and imply that it is not necessarily just a matter of putting more money into the public sector to increase retention.en_ZA
dc.identifier.apacitationAshmore, J. (2013). 'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa. <i>Human Resources for Health</i>, http://hdl.handle.net/11427/15235en_ZA
dc.identifier.chicagocitationAshmore, John "'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa." <i>Human Resources for Health</i> (2013) http://hdl.handle.net/11427/15235en_ZA
dc.identifier.citationAshmore, J. (2013). Going private’: a qualitative comparison of medical specialists’ job satisfaction in the public and private sectors of South Africa. Hum Resour Health, 11(1), 1.en_ZA
dc.identifier.ris TY - Journal Article AU - Ashmore, John AB - BACKGROUND: There is a highly inequitable distribution of health workers between public and private sectors in South Africa, partly due to within-country migration trends. This article elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivize retention in the public sector. METHODS: Seventy-four qualitative interviews were conducted - among specialists and key informants - based in one public and one private urban hospital in South Africa. Interviews were coded to determine common job satisfaction factors, both financial and non-financial in nature. This served as background to a broader study on the impacts of specialist 'dual practice', that is, moonlighting. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Respondents were thus able to compare what was satisfying about these sectors, having experience of both. RESULTS: Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work can be attractive in some ways. For example, the public hospital sector generally provides more of a team environment, more academic opportunities, and greater opportunities to feel 'needed' and 'relevant'. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. CONCLUSIONS: The results are useful for understanding both what brings specialists to migrate to the private sector, and what keeps some working in the public sector. Policy recommendations center around boosting public sector resources and building trust of the public sector through including health workers more in decision-making, inter alia. These interventions may be more cost-effective for retention than wage increases, and imply that it is not necessarily just a matter of putting more money into the public sector to increase retention. DA - 2013 DB - OpenUCT DO - 10.1186/1478-4491-11-1 DP - University of Cape Town J1 - Human Resources for Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2013 T1 - 'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa TI - 'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa UR - http://hdl.handle.net/11427/15235 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15235
dc.identifier.urihttp://dx.doi.org/10.1186/1478-4491-11-1
dc.identifier.vancouvercitationAshmore J. 'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa. Human Resources for Health. 2013; http://hdl.handle.net/11427/15235.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2013 Ashmore; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceHuman Resources for Healthen_ZA
dc.source.urihttp://www.human-resources-health.com/en_ZA
dc.subject.otherJob satisfactionen_ZA
dc.subject.otherRetentionen_ZA
dc.subject.otherPrivate sectoren_ZA
dc.subject.otherMotivationen_ZA
dc.title'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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