Evaluation of relationship between leadership style and job satisfaction amongst healthcare professionals

Introduction: Leadership is viewed as a process by which people bring out the best in themselves. Transformational leadership, transactional leadership and laissez faire leadership are the three common leadership styles. Leadership styles are related to job satisfaction to varying degrees. Hence the overall aim of this study is to investigate relationship between the leadership style and job satisfaction amongst medical, dental and physiotherapy professionals working in same institute. Methodology: This is a questionnaire based descriptive study. Leadership style was evaluated using Bass's Multifactor Leadership Questionnaire and job satisfaction was measured by Warr, Cook, and Wall's job satisfaction questionnaire. Result: The results show that both transformational and transactional leadership are positively related to job satisfaction, with correlations of 0.49 and 0.21, respectively. The two attributes negatively related with job satisfaction were transactional leadership (management by exception) lasseiz faire leadership with correlation of -0.120 and -0.160 respectively. Conclusion: The findings supported a strong relationship between various leadership styles and job satisfaction. This study highlights need for creating awareness about leadership style and job satisfaction and also training healthcare workers towards acquiring leadership skills to embrace challenges for high quality equitable health care.


Introduction
Effective leadership is one of the most crucial factors that lead an organization towards success. Leadership is the ability to influence a group toward the achievement of its goals 1,2 . Job satisfaction is the extent to which the employees are content with their job. Higher amount of job satisfaction leads to higher commitment towards their work and increased productivity. In context of healthcare institution this also reflects on quality of patient care and academic activities.
Although the effect of leadership styles on job satisfaction has been reported in the literature, the study subjects are primarily nurses and therefore findings are context specific. Leadership and its relation to job satisfaction has not been investigated amongst different disciplines of healthcare professionals.
Therefore this research was undertaken in order to establish a relationship between the leadership style and job satisfaction amongst medical, dental and physiotherapy professionals working in same institute.

Methodology
This study used a descriptive design with a self-report survey instrument. The survey questionnaire included minimal demographic information to group the data for analysis by type of position held.
All teaching staff of a healthcare institute including medical, dental and physiotherapy colleges were included.
Leadership style was evaluated using Bass's Multifactor Leadership Questionnaire and satisfaction was measured by Warr, Cook, and Wall's job satisfaction questionnaire.
The data collectors provided each staff member with a cover letter explaining the study and a questionnaire with return envelope. Anonymity was assured by including no identifying information on the questionnaires or envelopes. Return of the questionnaire verified consent to participate. Participation was strictly voluntary. Data were collected during a 2-week period.
Data was tabulated and statistically analysed using SPSS software.

Results
Out of 157 employees 87 returned the filled questionnaires. 20 were omitted due to missing items and invalid scores.

Discussion
Leadership is a trait whereby one influences the other by personality and intellect rather than violence and threat. An effective leadership style creates impetus for transformation. Literature on leadership identifies transformational leadership, transactional leadership and laissez-faire leadership as three common styles.
Transformational leadership is a process in which leaders and followers raise one another to higher levels of motivation and morality. This motivation enhances followers work oriented values and shapes their self efficacies, energizes people to perform beyond expectations by creating a sense of ownership in reaching the vision 1,2 .
Transformational leadership includes four attributes: ideolized influence, inspirational motivation, intellectual stimulation, and individualized consideration. Ideolized influence (role modelling) is a process whereby the leader provides followers with a vision and a sense of mission and gains respect, trust, and confidence from followers. Inspirational leaders engage in confidence building of their subordinates, thereby influencing their ability to perform assignments and tasks successfully. Intellectual stimulation is a process whereby the leader increases follower awareness of problems and influences followers to view problems from a new perspective. Individualized consideration includes providing support, encouragement, and developmental experiences for followers 1,2 .
In contrast, transactional leadership pursues a cost-benefit, economic exchange to meet subordinates' current material and psychic needs in return for contracted services rendered by the subordinate 1,2 .Transactional leadership will be operationalized in this study using the following attributes Contingent Reward leaders tell others what to do in order to be rewarded, emphasize what you expect from them and recognize their accomplishments, Management-by-Exception where leaders tell others the job requirements, are content with standard performance, and are a believer in "if it ain't broke, don't fix it." Laissez-Faire leaders require little of others, are content to let things ride, and let others do their own thing. It is a passive style reflected by high levels of avoidance, indecisiveness and indifference. The leader assumes that followers are intrinsically motivated and should be left alone to accomplish the task. Maintaining status quo, negative feedback, and flexible use of punishment versus reward are typical behaviors of such leaders.
Job satisfaction is the positive overall feelings that individuals have towards their job. War, cook and Wall's job satisfaction questionnaire measures job satisfaction on a five point likert scale and higher the score higher job satisfaction. There are nine parameters including amount of variety in job, opportunities to use abilities, freedom of working method, amount of responsibility, physical working condition, hours of work, income, recognition for work, collegues & fellow workers.
In the present study, all attributes of transformational leadership were strongly associated with higher job satisfaction. The results are in accordance with previous studies [1][2][3][4] . Management by exception and Laissez-Faire styles were found to be having negative influence on job satisfaction. This is in accordance with previous studies 4,5 .
Several research studies in the field of leadership found that transformational leadership attributes and behaviors were positively related to organizational outcomes such as teamwork success, effectiveness, staff satisfaction, commitment and extra effort and more. Moreover, transformational leadership processes have been found to enhance followers' work-oriented values and shape self-efficiencies of followers 7 . An effective leader is an effective change agent.
Rather than maintaining status quo or waiting for others to make mistakes and then rectify them or doing nothing, actively engaging in self growth by understanding current challenges, anticipating future needs and being a part of growth of others can lead to better work outputs.

Conclusion
Leadership style influences job satisfaction amongst healthcare professionals. Transformational leadership is positively related to job satisfaction and management by exception and lasseiz faire leadership styles are negatively related to job satisfaction. In view of this, there has to be sensitization of healthcare professionals about this topic of leadership styles and encouragement towards adopting transformational leadership style consciously to optimize their performance and better patient care.

Take Home Messages
Leadership styles and job satisfaction are inter-related. If healthcare professionals are made aware about this fact and trained to adopt favourable leadership behaviours, their job satisfaction and work efficiency can be optimized.