Professionalism, a sense of duty, and fairness

By taha No comments

I was recently shared an article from a surgeon about his experience with how vacation time worked at his hospital. His hospital had recently instituted a policy that surgeons (who don’t have a fixed hour workweek) could take more than their allotted leaves if they forfeited their pay for the extra days they took off. According to the author, this policy transformed the way he looked at his job. He was now okay with taking more vacation days because he now saw his time as barter for money at the hospital, as opposed to before where he behaved as a professional should, so to say work as many hours as it took to do the job.

This got me thinking about how remuneration works, especially for professions which serve the public. In most cases, they are paid a fixed wage, and are also expected to work many hours each day. This is true for doctors, public prosecutors, judges, engineers, police, and teachers, amongst others. As a society, we have transported a model of working which works for the private sector (where remuneration is based on amount of work done or hours worked) into professions where the time involved to finish a job is almost always unclear. This has worked simply because of this sense of professionalism that the author talks about. But given the important role in our society of these professions, specially for those working in the public sector, this model of working needs to be rethought, but in a way that does not compromise the sense of ownership and professionalism that members of these sectors feel.

Making changes, however, is easier said than done. In the public sector, where there is always a scarcity of resources, the government can’t simply pay them a lot more that easily. However, the ROI (return on investment) on paying professionals more can be quite large. A 2006 study done on police pay and performance in the US indicated that if the pay is below the reference the servicepeople set for themselves (as individuals and as a collective union), their work performance is significantly lower than when their pay requirements are met. The study emphasised that considerations of fairness and ‘fair’ pay determined how officers felt, as opposed to a simple market labour rate.

Similarly, in healthcare, the idea of fairness might be intrinsically linked to performance as well, even when higher personal income is not the reward itself. In a study done at the NHS in the UK, which introduced a pay-for-performance program at its hospitals in 2008, mortality rates were lowered when healthcare workers were rewarded for good performance. In a tournament based system where hospitals in the top quartiles were awarded bonuses, there was a significant reduction in mortality for diseases like pneumonia. The higher-performing clinics in the hospitals were allocated the bonuses in the form of increased investment in the clinics themselves rather than higher personal incomes – suggesting that simply rewarding institutions as a whole as a form of fairer payment for better work done rather than increasing personal incomes might lead to a higher quality of care.

When it comes to vacation days and paid-time off, there has been an increasing trend of unlimited vacation days in tech companies, especially in the United States. Studies done on these policies show that they result in increased employee satisfaction and higher performance. While policies like these are ripe to be abused, evidence suggests that such abuse is rare. It makes sense for employees who take great pride in their work to be treated like adults and trust them to decide what vacation suits them.

I feel like the author in the article mentioned at the beginning would find an unlimited vacation time policy a good compromise between seeing his time as transactional versus not having the flexibility to go on longer holidays every once in a while. In the presence of sufficient safeguards (advanced notice for vacation time, redundancy in manpower where required etc), this policy might not only fulfil the ‘fair’ reward principle but also increase loyalty towards institutions where the employees are treated well and as responsible adults.