Expanded Summary

Motivation is defined as human effort, striving, stimulation process for successful work and achievement of organizational goals. It develops as a result of the interaction of individual, organizational and cultural factors. The research question is to evaluate and analyze the characteristics of motivation and job satisfaction in the primary health care system in Georgia. Primary health care is the most equitable and effective strategy to improve the health of the population. The relevance of the issue is indicated by the poorly developed aspect of the primary health care system in Georgia.

The purpose of the study is to study the factors determining the motivation and job satisfaction of primary health care personnel in Georgia, to determine their influence on the ability to achieve professional goals.

The results of the study showed that the successful and effective work of the medical organization is largely related to the job satisfaction of the medical staff. The doctor's satisfaction with his work significantly improves the services he provides and positively affects the patient's satisfaction level. The doctor's behavior with his colleagues, as well as the relationship between the doctor and the patient, depends on his level of job satisfaction.

Job satisfaction of doctors is influenced by both activity and personal characteristics. The most important factors were identified as: relationship with patients, intellectual stimulation, opportunity for continuous medical education, job satisfaction, relationship with colleagues and management.

Job satisfaction is significantly determined by the possibility of professional development. The study confirmed that one of the most important challenges is the critical shortage of properly trained personnel. From the point of view of the possibility of professional development, we studied several issues: the possibility of taking trainings, conducting trainings with high intensity, how high is the involvement of employees in trainings, how much trainings help in improving practical skills.

Most of the family doctors (50%; n=81) believe that they have the opportunity to receive training; However, training opportunities are very low for nurses; 34.6% of nurses believe that they do not have the opportunity to receive trainings; 29% of family doctors and 34.6% of nurses believe that trainings are not conducted with high intensity; The majority of family doctors (40.7.5% partially and 28.4% fully) believe that employee involvement in trainings is not high; 54.9% of family doctors and 46.9% of nurses believe that trainings help to improve practical skills.

The mentioned results may be caused by the fact that incentives for continuous medical education and continuous professional development have not been implemented in Georgia, which make it very attractive and even necessary for the doctor to constantly update his knowledge. Such incentives are: career growth guarantee, salary increase, bonuses, contracting only those doctors who participate in continuous medical education. The low level of professional education of nurses is especially alarming.

Job satisfaction is influenced by the working environment and conditions of the organization. Good working conditions contribute to the willingness of medical staff to serve patients better. On the other hand, in a satisfactory environment, patients develop motivation to often turn to their family doctor when needed, where they can calmly explain their complaints.

We studied the impact of working conditions on job satisfaction according to several issues: how timely is the response to a technical fault in the work process, how well do the work items (medical, technical inventory, stationery) correspond to the requirements and needs, how comfortable is the territorial location, how satisfied are they with the physical conditions. According to the respondents, the improvement of the working environment and conditions of their organization had a positive effect on their motivation to work better, as well as on their mood to provide high quality service to patients. In recent years, the buildings, doctor's offices, and procedure rooms have been renovated and improved. They are equipped with all necessary medicines and necessary equipment.

The research showed that 36.4% of family doctors and 30.2% of nurses believe that there is a timely response to a technical error in the work process; 43.2% of family doctors and 37.7% of nurses believe that work items (medical, technical inventory, stationery) correspond to their requirements and needs. 43.2% of family doctors and 37.7% of nurses believe that the territorial location is quite comfortable for them; 54.3% of family doctors and 46.3% of nurses believe that they are satisfied with physical conditions.

One of the important factors determining job satisfaction is the relationship with managers. The relationship with managers was studied considering the following issues: how much managers think about their well-being, how much they have the opportunity to freely express their opinion when talking to managers, how much the manager ignores the employee's suggestions for improving the work, how much support from the manager helps in quality work, whether the manager praises when he does a good job , the extent to which the manager points out deficiencies when things need improvement.

Family doctors (34.6%) and nurses (22.2%) believe that managers think less about their well-being; 58% of family doctors and 47.5% of nurses believe that they always have the opportunity to freely express their opinion when talking to managers; 65.4% of family doctors and 57.4% of nurses believe that managers' decisions regarding employee promotion are fair; 51.9% of family doctors and 50% of nurses do not agree with the opinion that the manager ignores the employee's suggestion to improve work; 66% of family doctors and 59.3% of nurses believe that support from the manager helps them to perform their work well; 69.1% of family doctors and 64.2% of nurses believe that the manager praises when he does his job well; 52.5% of family doctors and 48.1% of nurses believe that the manager indicated when things needed to be improved.

As a result of the conducted research, the main factors that influence the job satisfaction of employees in primary care organizations were identified: individual characteristics (eg, calling), financial and non-financial external incentives, organizational structures and processes, including supervision, leadership, fairness and responsibility for the distribution of resources, Staff dynamics and team cohesion, relationships with colleagues and management, relationships with patients, intellectual stimulation, opportunities for continuing medical education. We can conclude that the level of satisfaction does not depend on one specific factor and many factors play a decisive role. Accordingly, a doctor's high satisfaction with his work significantly improves the services he provides and has a positive impact on the patient's satisfaction and well-being, which is the main goal of any medical organization.

Research shows that health policy makers, planners and managers need to critically analyze the importance of providing additional incentives. In order to improve the job satisfaction of health workers, in addition to salary, special emphasis should be placed on supporting family life, creating decent living conditions, educational prospects and adequate free time. In addition, attention should be paid to other non-financial incentives such as educational training, better opportunities and opportunities for professional development and promotion, which are likely to lead to greater job satisfaction.

Thus, in conclusion, motivation and job satisfaction are complex constructs that are influenced by different types of factors at different levels. Understanding motivation and job satisfaction can facilitate the development of programmatic recommendations that further enhance the effectiveness of health systems.

Keywords: motivation, job satisfaction, health policy, primary health care, family doctors