Is Psychological Contract Relevant in the Healthcare Sector?

Introduction

Businesses in the present digitized millennium considers the skilled and competent knowledge workers along with their complex bundle of values as the assets of an organization and the main key to innovation and growth. Commitment, engagement, involvement and integrity of the employees are the values that lead an organization towards sustainability and progress by creating long-lasting relationships with external and internal stakeholders (Robert, G. E. et al., 2012). It is beyond doubt that, high customer experience and business value is achieved through well-trained, committed and competent employees, who are the ones coordinating between customers and organizational goals. It is crucial for any organization to maintain positive interpersonal relationships with the employees in order to achieve its ultimate goals (Patrick & Priscilla, 2019). Psychological contract explains the root of existence of contemporary employment relationships in modern workplaces (Maria Tomprou, 2011) leading to values of commitment, engagement and empowerment among the employees irrespective of the nature of job and industry. The dynamism in the business environment, depreciating labor market and organizational transitions has made it challenging to retain talented and productive employees in the fast-booming Healthcare sector.

Globally, healthcare sector is projected to grow at an annual rate of 4.1% in the period between 2017-2021, up from simply 1.3% in 2012-2016 (Economic Survey report, 2017-18). Robust growth mandates committed employees and effective talent management programs. This is where Psychological contract becomes an inevitable key to enabling organisations balance the increased expectations of healthcare professionals (doctors, nurses etc.) and maintain commitment and contributions as per organisational goals. The concept of psychological contract has captured the attention of researchers as a framework for understanding the employment relationship (Coyle-Shapiro, Jacqueline A-M. & Parzefall, M., 2008), managing mutual expectations, needs, commitment and reciprocal contributions as per organisational standards contributing to talent management and growth (Taylor & Tekleab, 2004).

India is expected to rank amongst the top three healthcare markets worldwide in terms of incremental growth by 2020 as per the SEPC report. According to a study by National Healthcare Retention and Registered Nurse Staffing Report, the average hospital turnover rate in 2017 was 18.2%, which is the highest recorded turnover in the industry for almost a decade (Wells, M., 2015). The rising turnover rate of employees in healthcare industry is possibly due to lack of work engagement, lower job security and personal safety of healthcare professionals, lack of training and professional development, less adoption of newer technologies, challenging work-life balance and high stress levels in the hospitals (Warrier, 2017).

The high stress levels, challenges and accountability involved in the job roles mandates psychological contract to exist as a talent retention strategy. The healthcare professionals need to deal with patients who may be upset or scared, the doctors are often required to disclose tragic news to patients and their family members that leads to critical attacks on them. Safety, security and stress of the healthcare professionals is a major concern in an emerging country like India, raising constraints for doctors and nurses to perform their job better. Healthcare professionals do not often have a choice in their day-to-day lives and find it difficult to find social support from the hospital management. This impacts their psychological contract adversely leading to burnout, low commitment, poor behavioural outcomes and degrading healthcare services offered to the patients. Psychological contract describes the understandings, beliefs and commitments that exist between an employee and employer (Patrick, H., 2008). It is important to identify the determinants that affect the psychological contract of professionals in healthcare sector and to identify the reasons beyond it as well as consequences. The ultimate outcome is retention and undeterred employee performance.