Safety and Health at Work 5 (2014) 198e202

Contents lists available at ScienceDirect

Safety and Health at Work

journal homepage: www.e-shaw.org

Original Article

The Impact of Robotics on Employment and Motivation of Employees

in the Service Sector, with Special Reference to Health Care
Mohammed Owais Qureshi 1, Rumaiya Sajjad Syed 2, *
1
Department of Human Resource Management, College of Business, King AbdulAziz University, Rabigh, Saudi Arabia
2
Department of Health and Hospital Management, College of Business, King AbdulAziz University, Rabigh, Saudi Arabia

a r t i c l e i n f o a b s t r a c t

Article history: Background: The economy is being lifted by the new concept of robotics, but we cannot be sure of all the
Received 14 February 2014 possible benefits. At this early stage, it therefore becomes important to find out the possible benefits/
Accepted 14 July 2014 limitations associated with robotics, so that the positives can be capitalized, established, and developed
Available online 29 July 2014
further for the employment and motivation of employees in the health care sector, for overall economic
development. The negatives should also be further studied and mitigated.
Keywords:
Methods: This study is an exploratory research, based on secondary data, such as books on topics related
employment
to robotics, websites, public websites of concerned departments for data and statistics, journals, news-
health care sector
motivation papers and magazines, websites of health care providers, and different printed materials (brochures, etc).
robotics Results: The impact of robotics has both positive and negative impacts on the employment and moti-
vation of employees in the retail sector. So far, there has been no substantial research done into robotics,
especially in the health care sector.
Conclusion: Replacing employees with robots is an inevitable choice for organizations in the service
sector, more so in the health care sector because of the challenging and sometimes unhealthy working
environments, but, at the same time, the researchers propose that it should be done in a manner that
helps in improving the employment and motivation of employees in this sector.
Ó 2014, Occupational Safety and Health Research Institute. Published by Elsevier. All rights reserved.

1. Introduction In the past couple of decades the advancement in the technol-

ogy of robotics has been enormous but at the same time there has
In this era of information explosion, human capital has become not been much research conducted on the effects of the robotics on
one of the main driving forces behind the economic success of the employment and motivation of employees in the service sector,
service sector organizations. This is especially true in the health or in health care in particular. This research focuses on the impact of
care sector, which, according to Centers for Medicare and robotics on the employment and motivation of employees in the
Medicaid Services [24], consumes over 10% of gross domestic service sector with special reference to health care.
product (GDP) of most developed nations. As a share of the
economy, health care has risen from 7.2% of GDP in 1965 to over 1.1. Statement of the problem
16% of GDP today, and it is projected to be 20% of GDP just 10
years. Thus, it has become even more important that human re- Organizations today are faced with increasing labor costs and a
sources’ in the health care should be managed well and, to do so, shortage of workers, and are thus investing in robotics. Robots
an integration of innovative technology with the day-to-day ac- never demand raises and are able to work around the clock. Robots
tivities of employees should be the prime focus of organizations can perform tasks that most humans could not possibly do, such as
operating in health care. working in challenging conditions and being able to purport

* Corresponding author. Department of Health and Hospital Management (Female Section), King AbdulAziz University, Rabigh 21911, Saudi Arabia.
E-mail address: [email protected] (R.S. Syed).

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0)
which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

2093-7911/$ e see front matter Ó 2014, Occupational Safety and Health Research Institute. Published by Elsevier. All rights reserved.
http://dx.doi.org/10.1016/j.shaw.2014.07.003
 M.O. Qureshi and R.S. Syed / Impact of Robots on Employment 199

amazing feats with utmost precision. What makes a firm ready for has announced plans to add more than one million robots to its
the challenges of the future is not just technology but the man- workforce. It still has a long way to go, however, as only about
agement of human resources, especially the impact of robots on the 20,000 are currently in use [5].
employment and motivation of employees in the health care sector. According to the International Federation of Robotics, overall
paid employment has risen in most countries including Brazil,
1.2. Objective of the study China, Republic of Korea, Germany, and USA, but not Japan, which
has seen a decline. The statistics mainly show a reduction in
The main objective of the research is to shed light on the facil- employment in manufacturing in the developed countries, often a
itation of robotics in health care and its impact on the employment small reduction. This coincides with an increase in output and an
and motivation of employees, and also to assess its possible ad- increase in robotics use, except in the case of Japan. The robot in-
vantages/disadvantages. This is with the intention to raise aware- dustry itself generates 170,000e190,000 jobs worldwide, to which
ness about positive and negative effects of robotics on the can be added the support staff and operators, another similar
employees of the health care sector, and finally developing strate- number of people. Despite the rapid increase in the use of robots,
gies for its use in small, medium, and large health care service USA has proportionately half the number of robots used by Ger-
providers. This research also provides a basis to study the various many. Germany itself (partly because of a different industry mix) is
factors that should be responsible for attracting the health care third, behind Japan and Korea. The concept of “jobless recovery”,
providers to use robotics in their operations. where an industry comes out of a recession leaner, needing fewer
To achieve the main objective, the following subobjectives were employees, is only short term. It is likely to lead to more job crea-
set: (1) assess the impact of robotics on employment and employee tion by the leaner, more competitive companies. At the same time,
motivation; (2) assess the impact of robotics on health care; and (3) the service sector continues to absorb most of the displaced people.
assess the impact of robotics on employment and employee moti- Some of these new service people owe their jobs to a new robot
vation in health care. driven industry. The research by the International Federation of
Robotics further points out that, although automation displaces
1.3. Research methodology people in manufacturing, it almost always increases output.
In some cases this allows such an increase in production and
The research is based on secondary data taken from different related decrease in unit price, that creates a whole new market and
books on the related topics, web portals, public websites of con- generates the need for downstream jobs to get the product to the
cerned departments for data and other statistics, various journals, consumer. This releases employees for other, often new jobs outside
newspapers and magazines, websites of selected health care pro- manufacturing. An alternative view is that this displacement in the
viders, as well as different printed materials (brochures, etc.) future will be more difficult to place, as service robotics may take
collected from them. Substantial information has been gathered over some or many of the new job opportunities in human tasks such
from these sources thus allowing for appropriate analysis, compi- as in banking, fast food chains, and retailing petrol forecourts [6].
lation, interpretation, and structuring of the entire study. Thus, in David Sims in his blog reports that Drew Greenblatt, the presi-
an attempt to isolate and categorize potential sources of robotics dent of Marlin Steel (MD, United States), an American company that
and its impact on the employment and motivation of employees in manufactures wire baskets and sheet metal products praises the
the health care sector, the available literature is reviewed. way robots have helped his company grow 25% and increase
operational safety [7]. Greenblatt told Inc.com that when he bought
2. Materials and methods the company, which was the largest bagel basket maker in the
country, in the late 1990s, “the most modern technology in the
2.1. Literature review plant was a fax machine,” and the top workers could produce a
basket by hand every 12 seconds. Today, robots can make five
A robot is a system that contains sensors, control systems, ma- baskets per second, with precision that is “light years beyond what
nipulators power supplies, and software all working together to we were capable of before.” Greenblatt argues that robots have
perform a task [1]. made his workers more valuable and highly paid than their com-
Motivation is an employee’s intrinsic enthusiasm about and petitors. “Recently, we won a huge order for sheet metal brackets,”
drive to accomplish activities related to work. Motivation is that he noted. “The brackets were formerly made in China by workers
internal drive that causes an individual to decide to take action [2]. who earned $2.50 an hour and produced perhaps 50 an hour. Our
The service sector consists of the “soft” parts of the economy, i.e., sheet metal operator earns 10 times that rate, but sets up a robot
activities where people offer their knowledge and time to improve that produces 2,000 brackets an hour.” [8].
productivity, performance, potential, and sustainability. The basic However, critics of the automation boom claim that such tech-
characteristic of this sector is the production of services instead of nological advancements are killing off middle-class jobs. Robots
end products. Services (also known as “intangible goods”) include and automated systems have not only eliminated elevator operators
attention, advice, access, experience, and discussion [3]. and highway toll collectors, but are also making inroads into higher-
Health care is the diagnosis, treatment, and prevention of dis- skilled job functions, and the long-term effect in job losses among
ease, illness, injury, and other physical and mental impairments in human workers may be much more severe than most expect [7].
humans. Health care can form a significant part of a country’s
economy. In 2008, the health care industry consumed an average of 2.3. Impact of robotics in health care
9.0% of the GDP across the most developed OECD countries. The
USA (16.0%), France (11.2%), and Switzerland (10.7%) were the top The Robotics for Healthcare study was funded by the European
three spenders [4]. Commission, DG Information Society and Media, with the aim to
investigate and develop a roadmap for the application of robotics in
2.2. Impact of robotics on employment and employee motivation medicine and health care [9].
According to Kinetic consulting, by 2050 one in four people in
Companies such as iPhone manufacturer Foxconn (New Taipei the United Kingdom will be over the age of 65 years. Japan’s pop-
City, Taiwan), which has been plagued by a series of labor scandals, ulation is the most rapidly ageing in the worldd30 million people,
200 Saf Health Work 2014;5:198e202

accounting for 25% of the population, are over the age of 65 years. The company hopes to commercialize the products sometime after
To meet this challenge, health and local authority services must 2013 [9].
reconfigure, placing greater emphasis on community care and the There is a well-documented shortage of nurses and direct-care
effective use of technology. One promising technology is robotics workers in the United States and around the world, which is ex-
[10]. pected to become more problematic as the older adult population
Compared with humans, robots may be quicker to train, cheaper grows and prepares for retirement. In a study of the effects of high
to maintain, easier to refuel and repair, and less prone to be bored patient-to-nurse ratio, Aiken et al [25] showed that each additional
by repetitive tasks. They could help the elderly and chronically ill to patient per nurse was associated with a 7% increase in patient
remain independent, reducing the need for carers and the demand mortality and a 23% increase in nurse burnout. Consequently,
for care homes [10]. studies have suggested that lowering the patient-to-nurse ratio
According to a renowned blogging site, called information week, would result in less missed patient care [20]. Thus robotics can play
since 2000, the da Vinci Surgical System, has conducted more than a role in assisting nurses to complete their daily tasks in order to
20,000 surgeries and has paved the way for robotic advancements provide better health care.
in health care. In fact, vendors have introduced a number of new Robotic systems in nursing care to support the arduous work of
robots to better provide care to remote patients, help with various the individual professional and to counteract the imminent staff
physical therapies anddsimilar to the da Vinci systemdhelp shortages [9]. The pharmaceutical industry is continuously
perform surgery. For example, Magnetic Microbots are a group of improving quality and increasing quantity of their products. Health
tiny robots used in various operations, such as removing plaque care systems are being set up in more and more countries. The
from a patient’s arteries or helping with ocular conditions and worldwide demand for pharmaceutical products is on the rise. The
disease screenings. Other robotic advancements are used to better pharmaceutical industry was hardly affected by the economic
the day-to-day lives of patients, helping them eat, such as the Bestic crisis. Thus, investments in robots only slightly decreased in 2009.
Arm, or helping a patient regain her ability to walk, like many of Similar trends can also be observed in the medical devices industry.
Toyota’s Healthcare Assistants [11]. In both industries, robot installations will gain momentum in the
In the next few years, thousands of “service robots” are expected coming years [6].
to enter the health care sectordpicture R2-D2 from Star Wars
carrying a tray of medications or a load of laundry down hospital 2.4. Impact of robotics on employment and employee motivation in
corridors. Fewer than 1,000 of these blue-collar robots currently health care
roam about hospitals, but those numbers are expected to grow
quickly [12]. Mid-level hospital jobs that don not require a bachelor’s degree
Robots such as the Aethon TUG, according to the company, are quickly disappearing. The Wall Street Journal reports that positions
working just two shifts 7 days per week, saves the labor of 2.8 full- such as licensed practical nurses and medical-records clerks are being
time equivalent (FTE) employees, yet costs less than a single FTE. eliminated or pushed out of hospitals into lower-paying corners of
Aethon TUG safely navigates through hospital corridors, elevators, the field such as nursing homes. Meanwhile, positions that were once
and departments to get items from point A to point B. It rolls 24 an accessible first rung on the career ladder, such as registered
hours, 7 days a week to make both scheduled and on-demand nursing, increasingly require at least a bachelor’s degree [21].
deliveries, and never gets sidetracked from its mission [13]. Swis- Most of the experts interviewed by the Wall Street Journal were
slog’s RoboCourier, a similar delivery system, increases staff effi- worried about all these job-stealing robots. Health care, after all,
ciency with a run-time of 11 hours/day [14]. has become one of the last remaining fields in which one could earn
Giraff is a mobile communication solution that facilitates the one’s way to a middle-class lifestyle without a college degree. In a
elderly’s contact with the outside world. It is remote-controlled, on time of growing economic inequality, the elimination of these jobs
wheels, and has a camera and monitor [15]. seems discouraging. Although the costs are real, there are also
Another robot, called RP-VITA, is a result of a joint development plenty of upsides. The most obvious are the efficiency gains that
effort between iRobot and Intouch Health. The system features come with automation. Robots can do some jobs better, cheaper,
mapping and obstacle detection, as well as avoidance technology and faster than humans. They can transcribe and store information,
and an iPad user interface for control and interaction. The robot can help doctors and nurses diagnose their patients, and even allow
also interface with diagnostic devices and electronic medical re- lower-skilled health care workers to treat patients with less over-
cords systems. The remote rig will eventually be able to navigate to sight from doctors and other higher-skilled workers [22].
specified target destinations autonomously [16]. SingularityHub, a leading technology blog, reports that El Camino
Bestic is a unique innovation for those who want to eat by Hospital in Silicon Valley is looking to cut expenses, so they’ve
themselves without requiring help from others. Bestic is a robotic- invested in 19 Aethon TUG robots. These smart carts can haul sup-
assisted dining appliance for people who are unable to move their plies around the hospital, making deliveries and pickups at a fraction
arms or hands. It is designed to be an integral part of a meal by of the costs of human workers. El Camino Hospital, CA, United States
being easily accessible and convenient in a manner that does not recently announced that it would further be cutting costs by firing up
intrude on a dignified and pleasant eating experience [17]. to 140 workers from its two facilities in Los Gatos and Mountain
A robot called Cosmobot is used by doctors to enhance the therapy View. According to a hospital administrator quoted in the Busi-
of developmentally disabled children aged 5e12 years. Using the nessweek article the 19 TUGs perform $1 million of human labor/
robot can make therapy more interesting for children and allows for year, but only cost $350,000. A 65% reduction in labor costs [23].
better success when achieving long-term therapy goals [18].
A robot called AnyBots provides a type of immersive tele- 3. Results
presence, meaning instead of focusing merely on audio and video
communications, the AnyBots robot allows for movement So far there has been no substantial research done to assess the
controlled by a remote [19]. impact of robotics on the employment and motivation of em-
Toyota unveiled four robots designed to accomplish ambitious ployees in service sector, especially in the health care sector.
objectives at a Tokyo event. The robots help the paralyzed patients In the near future efficiency gains through the use of automation
walk or balance and help their caretakers gently transport them. will become more obvious and, thus, the installation of robots will
 M.O. Qureshi and R.S. Syed / Impact of Robots on Employment 201

gain momentum and will play an important role in assisting health Conflicts of interest
care professionals to complete their daily tasks and thus help in
providing better health care. All authors declare to have no financial or personal relationships
Although robots can do some jobs better, cheaper, and faster that could inappropriately influence the research described.
than humans in the service sector and are in huge demand at
various levels, which is always expected to increase in future, care Acknowledgment
should be taken regarding the employment and motivation of
employees, as human resources form the basis of competitive We would like to extend our thanks to overall administration
advantage for any organization. Thus, there should be viable focus and policy of King Abdulaziz University in general in encouraging
on training and development of employees, so as to meet the future and promoting the research activities. Also, we would like to extend
challenges posed by the introduction of robotics. The researchers our gratefulness to the Deanship of Scientific Research for their
point out that the organizations in the service sector especially in continuous support and guidance in conducting this study and
the health care can improve the performance of the employees by making it a reality.
emphasizing on excellent human resource practices such as
employment and motivation. References
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