The study matters because private clinics are increasingly becoming the first point of care for many Indonesians. While the number of clinics continues to rise, many facilities struggle to retain medical and administrative staff. High turnover not only disrupts operations but also threatens continuity of care and patient safety.
Why Turnover in Clinics Has Become a National Concern
Indonesia’s healthcare system has expanded significantly over the past two decades, driven by population growth and demand for accessible medical services. According to national health data, clinics now play a critical role alongside hospitals, especially in non-metropolitan areas. However, this expansion has created intense pressure on human resource management.
Private clinics often operate with limited budgets, high workloads, and restricted career pathways. As a result, employee turnover in the healthcare sector has surpassed many other industries. National labor statistics indicate that healthcare turnover rates regularly exceed 17 percent annually, with some facilities reporting even higher figures.
Mitra Medika Tambakan Clinic reflects this broader trend. Internal records show that employee resignations rose steadily between 2019 and 2023, creating staffing gaps and increasing workloads for remaining employees. This situation prompted researchers to examine what truly drives employees to stay or leave.
How the Study Was Conducted
The research analyzed responses from 126 employees, including medical staff such as nurses and midwives as well as non-medical personnel. Data were collected through structured questionnaires that measured perceptions of leadership, compensation, work motivation, and intention to resign.
To analyze the relationships between these factors, the researchers applied a quantitative statistical model that allows both direct and indirect effects to be observed. In simple terms, the method helped identify not only which factors matter most, but how they interact with each other in influencing employee decisions.
Key Findings: Leadership and Compensation Play Different Roles
The study uncovered several important insights that challenge common assumptions in human resource management:
- Leadership style directly reduces employees’ intention to resign. Employees who perceive their leaders as supportive, fair, and responsive are significantly less likely to consider leaving the organization.
- Leadership does not significantly increase work motivation. While leadership affects retention, it does not automatically translate into higher day-to-day motivation.
- Compensation strongly increases work motivation. Fair and competitive pay improves employees’ willingness to work and engage with their tasks.
- Compensation does not directly prevent employees from leaving. Higher pay alone does not guarantee retention.
- Work motivation significantly lowers turnover intention. Motivated employees show greater commitment and are less inclined to resign.
- Work motivation acts as a bridge between compensation and retention. Compensation reduces turnover intention only when it successfully boosts motivation.
These findings indicate that salary and leadership address different psychological needs. Pay influences how motivated employees feel, while leadership shapes whether they feel secure and valued enough to stay.
What This Means for Clinic Management
The results suggest that retention strategies in healthcare cannot rely on financial incentives alone. Clinics that focus exclusively on salaries may still lose employees if leadership quality is poor or organizational support is weak.
According to Padma Sari Sanjaya of UKRIDA, compensation works best as a motivational tool rather than a retention guarantee. She notes that employees are more likely to remain in organizations where leaders demonstrate fairness, clarity, and emotional awareness, even when financial resources are limited.
For clinic managers, this means:
- investing in leadership development and supervisory training,
- ensuring transparent communication and decision-making,
- designing compensation systems that support motivation rather than short-term satisfaction,
- and creating a work environment where employees feel psychologically safe.
Implications for Healthcare Policy and Public Services
Beyond individual clinics, the study has broader implications for healthcare governance. High turnover among healthcare workers can weaken service delivery, increase recruitment costs, and reduce patient trust. In regions with limited medical personnel, frequent staff changes can disrupt continuity of care.
Policymakers and healthcare regulators may use these findings to encourage leadership training programs, especially in primary care facilities. Strengthening managerial competence could be a cost-effective way to stabilize the healthcare workforce without relying solely on budget increases.
Research Limitations and Future Directions
The authors acknowledge that the study focused on a single clinic and used a cross-sectional design. Future research could expand to multiple regions, include longitudinal data, and examine additional factors such as job stress, work-life balance, and employee engagement.
Despite these limitations, the study offers practical insights grounded in real workplace conditions and contributes to ongoing discussions about sustainable healthcare management in Indonesia.
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