Performance of Basic Specialists Doctor in USU Hospitals and

the Influencing Factors

Zulfendri

, Gerry Silaban

, Arfah Mardiana Lubis

and Putri Citra Cinta Asyura Nasution

Fakultas Kesehatan Masyarakat, Universitas Sumatera Utara, Jl. Universitas No. 21, Medan, Indonesia

Keywords: Performance, Factor affetcing performance, Basic specialist doctor, Universitas Sumatera Utara Hospital.

Abstract: Performance of basic specialist doctor is accomplishments by internist, pediatric, general surgery, or

obstetrics and gynecology in doing his job corresponding with standard and criteria the specified

performance for work. However, there is no known picture of the performance of basic specialist doctors

and the factors that influence them. This qualitative research is done with interview to 4 informants,

incidentally, performance and work environment measurement at 4 rooms where informants work. Based on

the results, the performance of basic specialist doctors is less than the standard, especially in the aspects of

behavior and quantity of work. This is influenced by dissatisfaction factors on financial and organizational

culture in Universitas Sumatera Utara Hospital that is not results and people oriented, and there is no culture

of aggressiveness. This is made worse by the condition of the doctor's work environment that is not suitable

for working. Therefore, hospital management needs to pay attention to the financial benefits of basic

specialist doctors, results-oriented, people-oriented, and a culture of aggressiveness. The working

environment around the basic medical specialists also need to be improved, such as dry temperature 21-

24°C, the maximum noise intensity 45dBA, and the intensity of illumination 300-500 Lux.

1 INTRODUCTION

Based on opinion Rethans, et al. (2002), Rival, et al.

(2008), Mejia, et al. (2010), and Aamodt (2016),

performance is accomplishments by someone in

doing his job or his job corresponding with standard

and criteria the specified performance for work that.

Performance standards can be seen from four

perspectives, namely from the competence of the

doctor, from the tasks that must be completed by the

doctor, the purpose or work of the doctor, and the

nature of the doctor's work during work. Doctor

specialist basic is a doctor who specializes in

internist, pediatric, general surgery, and obstetrical

and gynecology (Tim Penerbit, 2002). By because

that, which is called as performance basic specialist

is accomplishments by a doctor who specializes in

internist, pediatric, surgery general, or obstetrics and

gynecology in doing his job or his job corresponding

with standard and criteria the specified performance

for work that. The basic specialist doctor

performance should be assessed so as to know the

level of achievement by the doctor.

According to Subanegara (2011), indicators

performance medical personnel who work at

hospital on a general is all over medical personnel

have privilege, completeness amount and type

specialist, have permission legitimate practice,

certified ATLS (Trauma Life Support) for doctor

who works in the IGD (Emergency Installation),

follow training technical 20 hours a year, accuracy

time service, time response service, time motion

service, service corresponding, procedure and

standard quality, implementing a patient safety

program, no error, the number of patients served,

satisfaction patient to doctor, magnitude revenue

generated doctor, and no malpractice demands to

doctor. Specifically for basic specialist doctor,

indicator performance used only based on coaching

and training obtained through various activities

scientific with collect 250-300 SKP (System Credit

Points) every five years later converted to

competence (Zulfendri, 2014). However, to achieve

this achievement is not easy. There are many factors

that influence the performance of the basic specialist

doctor.

Some research results by Nofrinaldi, et al.

(2006), Rejeki (2012), Cahyani, et al. (2013),

Arigemilia, et al. (2016), and Erlangga, Kasim, and

Meliala (2016), revealed that factors that affect

876

Zulfendri, ., Silaban, G., Lubis, A. and Nasution, P.

Performance of Basic Specialists Doctor in USU Hospitals and the Inﬂuencing Factors.

DOI: 10.5220/0010098008760879

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

876-879

ISBN: 978-989-758-449-7

performance basic specialist doctor is satisfaction

with services (medical services or remuneration),

satisfaction with the performance of doctors,

relationship between doctors and superiors,

organizational culture, work environment conditions

(good lighting and circulation, without noise and

odor and security at work), supervision, career level

clarity, and clarity of employment status.

Universitas Sumatera Utara Hospital (USU

Hospital) is one of the teaching hospitals in Medan.

However, from the results of interviews and

literature searches, it is not known the picture of

basic specialist doctor’s performance at USU

Hospital and the factors that influence it. Therefore,

this study was conducted to find out the description

of the performance of basic specialist doctors at

USU Hospital and the factors that influence it.

2 RESEARCH METHODS

This research is qualitative research and done at

Universitas Sumatra Utara Hospital. The data is

obtained with interview with 4 informants and

measurement of work environment. Determination

informant on incidental, ie doctors who are in place

when research do.

3 RESULTS AND DISCUSSION

The results showed that the performance of all

informants (4 people) less than the standard that has

been determined, especially on the behavioral

aspect, and 2 informants (obstetrics and gynecology

specialists and internist) on the aspect quantity of

work. The level of performance of these basic

specialist doctors is influenced by several factors.

On work satisfaction factor, basic specialist doctors

satisfied in several aspects, such as volume of work,

actual tasks, opportunities to progress, relationships

with colleagues, and attention of superiors, except

financial benefits.

Results revealed that all informants (4 people)

felt satisfied with the actual task, while the volume

of work, 3 informants (75%) feel satisfied and 1

informant (25%) felt enough satisfied. Satisfaction

that seen on some expression the informant who is

doctor specialist in obstetrics and gynecology "no

problem anyway, enough to be satisfied" related

time practice, because advantages patients amount

who have to served, and informants who are doctors

pediatric stated "yes it's okay, we are limited in time,

but we still serve patients".

Research results related to the work environment

reveal that 2 informants (50%) very satisfied and 2

informants (50%) felt satisfied. The results of this

questionnaire are supported by the statement of the

informant who was doctor pediatric "eee, there is no

dust, satisfied" related existence said a dust in room

practice. The results of questionnaires and

interviews with informants are in line with the

results of the measurement of dust concentration in 4

rooms where the informant work. The measurement

results in each room: 0.105 mg/m3, 0.102 mg/m3,

0.074 mg/m3, and 0.057 mg/m3. Based on the

Decree of the Minister of Health of the Republic of

Indonesia No. 1204 of 2004 concerning Hospital

Environmental Health Requirements, the standard

concentration of dust in a room in a hospital is not

exceeding 0,150 mg/m3, so it can be concluded in 4

of these rooms that it meets the standards.

The measurement results working climate, dry

climate, in each room: 23.1°C, 22.9°C, 23.5°C, and

25.2°C. Based on the Decree of the Minister of

Health of the Republic of Indonesia No. 1204 of

2004 on Environmental Health Requirements

Hospital, standard dry at room temperature in the

hospital, particularly the administrative and meeting

space, is 21-24°C, so it can be summed up in three

places already meet the standards, except Obstetrics

and Gynecology room, at 25.2°C.

Results of measurement of noise intensity level

in each room: 61.2dBA, 63.5dBA, 60.1dBA, and

64.4dBA. Based on the Decree of the Minister of

Health of the Republic of Indonesia No. 1204 of

2004 concerning Hospital Environmental Health

Requirements, standard noise intensity levels in

rooms in hospitals, especially public spaces, a

maximum of 45dBA, so it can be concluded, in 4

rooms that it does not meet the standards.

Results measurement of the intensity of lighting

in each room: 153 Lux, Lux 203, 184 Lux, and 183

Lux. Based on the Decree of the Minister of Health

of the Republic of Indonesia No. 1204 of 2004

concerning Hospital Environmental Health

Requirements, the standard intensity of lighting in

rooms in hospitals, especially public spaces, is a

minimum of 300 Lux and a maximum of 500 Lux,

while based on the results of measurements of 4

rooms under 300 Lux, so that it can concluded in 4

rooms that did not meet the standards.

Work climate, noise intensity, and lighting

intensity that do not comply with these standards

indicate poor environmental conditions for basic

specialist doctors to work. Whereas the condition of

Performance of Basic Specialists Doctor in USU Hospitals and the Inﬂuencing Factors

877

a good work environment, such as appropriate

conditions of repression, good circulation, and not

relevant, can affect the doctor's performance. Need a

comfortable work space that can create a

comfortable, quiet and safe work atmosphere that

supports the comfort of doctors in working (Hussin,

2011; Untari and Wahyuati, 2011; Cahyani, et al.,

2013; Rahmah, et al., 2013).

Based on the results of interviews related to the

attention of a supervisor, s, all informant feel there is

attention from the boss and is satisfied with the

attention. This was stated by the lack of oversight of

the performance of the entire informant, the

increased competence of all informants, and there

were career paths felt by 3 informants (75%).

However, the improvement in perceived competency

does not include the assistance of costs to develop

career profession from specialist become a sub-

specialist, as stated by one of the informants who is

a doctor specialist obstetrics and gynecology, "there

are, but pay for your self". While there is an

informant who is a doctor pediatric who does not

feel the opportunity at all for develop career from

functional to be structural, such as the statement of

the informant, "functional to structural! We have no

career path from functional to structural".

Intrinsic motivation (success, recognition/

appreciation, work itself, responsibility, and career

development) has a positive and significant effect on

the performance of doctors (Rahmah, et al., 2013).

Based on the results of the research by Untari and

Wahyuati (2014) and Suryani and Yarosi (2015), not

only intrinsic motivation can affect a person's

performance, but also competence and supervision.

Competency enhancement is needed which aims to

increase knowledge, skills and attitudes and existing

behavior (hard competency and soft competency).

Based on research, that supervision relates to

employee performance. Oversight is needed to

compare actual performance with established

standards, so it can find out if there is a deviation or

an improvement needs to be done.

Interview result related relationship with

colleague work, 1 informant (25%) felt very

satisfied and 3 informants (75%) felt satisfied. The

results of Rahmah's research (2013). revealed that

extrinsic motivation (interpersonal relationships and

working conditions) also influenced the performance

of doctors. The relationship between humans is a

characteristic of humans as social beings. Humans

need the existence of other human beings to give

each other judgment, communicate, help, support

and cooperate in life. Doctors also have a need for

good relationships with direct supervisors and

coworkers.

Based on the results of interviews regarding

financial factors revealed that 3 informants (75%)

felt enough satisfied and 1 informant (25%) felt less

satisfied with profit financially. Lack of feeling

satisfied seen on statement an informant who is a

doctor pediatric. The informant stated "incentive!

Less satisfied, we don't accept incentives" related

satisfaction doctor about magnitude incentive

received (excluding salary/services medical).

According to Aziri's research (2011) and

Dinarianti’s research (2011) that there is an

influence between incentives on performance.

In the organizational culture factor, all

informants feel that in USU Hospital, especially on

aspects innovation and risk taking, attention to

details, the team orientation, and stability. But the

informant who is an obstetrician and gynecologist

did not feel aspect result orientation, people

orientation and aggressiveness in the organizational

culture at USU Hospital. This will affect the

performance of basic specialist doctors. This is

supported by the results of research from Rejeki

(2012) and Handayani (2016) which revealed that

there was an influence of organizational culture on

the performance of doctors. The attitude and

behavior of human resources can change if they

consistently carry out work culture so that they can

achieve higher work productivity (Sudaryono,

2014).

4 CONCLUSIONS AND

SUGGESTIONS

Based on the results of the research and discussion at

this point, it can be concluded that the performance

of basic specialist doctors is less than the standard,

especially in the aspects of behavior and quantity of

work. This is influenced by dissatisfaction with the

financial and organizational culture in USU Hospital

that is not results oriented and people oriented, and

there is no culture of aggressiveness. This is made

worse by the condition of the doctor's work

environment that is not suitable for doctors in

working.

Therefore, hospital management needs to pay

attention to the financial benefits of basic specialist

doctors, people and results-oriented organizational

culture, and a culture of aggressiveness. The

working environment of all basic specialists also

needs to be improved, such as dry temperatures of

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

878

21-24°C, maximum noise intensity of 45 dBA, and

lighting intensity of 300-500 Lux, thus supporting

the comfort of basic specialist doctors in working.

ACKNOWLEDGEMENTS

Thanks to the Universitas Sumatera Utara which has

funded this applied research through DRPM

Kemenristekdikti funds for the fiscal year 2018.

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