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Factors affecting physician loyalty and exit: a longitudinal analysis of physician-hospital relationships
1Department of Management and Policy, College of Business and Public Administration, University of Arizona, Tucson 85721.
Insights
Physician hospital loyalty and exit are driven by convenience and inertia, not organizational commitment factors. Hospital strategies focusing on physician relations may have limited impact on physician admitting patterns.
Area of Science:
- Health Services Research
- Organizational Behavior
- Medical Economics
Background:
- Physicians' hospital admitting patterns are crucial for hospital success.
- Understanding physician loyalty and exit is vital for hospital management.
- Existing research often focuses on organizational commitment, but physician behavior may differ.
Purpose of the Study:
- To examine the factors influencing physician loyalty (admitting percentage) and exit (ceasing admissions) to hospitals.
- To test hypotheses derived from employee commitment and consumer buying behavior models.
- To determine the relative importance of convenience, inertia, and organizational commitment factors.
Main Methods:
- Analysis of physician admission data over a two-year period.
- Application of models from employee commitment and consumer behavior literature.
- Hypothesis testing to identify significant predictors of physician loyalty and exit.
Main Results:
- Physician admitting patterns are primarily explained by convenience and inertia, akin to consumer behavior.
- Factors related to organizational commitment, such as decision-making involvement and economic investments, showed minimal impact.
- Inertia and convenience were stronger predictors of physician loyalty and exit than commitment-related factors.
Conclusions:
- Hospital strategies aimed at improving physician-hospital relations climate may not effectively influence physician admitting patterns.
- Convenience and inertia are key drivers of physician hospital choice and retention.
- Future research on professional commitment should consider the distinct behavioral patterns observed in healthcare settings.
Abstract:
This article examines forces that influence physicians to change the percentage of their admissions to a hospital (loyalty) and to cease admitting patients to a hospital altogether (exit). Because physicians are both members of a hospital and consumers of its services, their admitting patterns can be described using models of employee commitment and consumer buying behavior. We test several hypotheses drawn from these literatures using data on physician admissions at hospitals over a two-year period. Results indicate that admitting patterns are explained primarily by convenience and inertia processes characteristic of consumer behavior. On the other hand, factors believed to influence organizational commitment (e.g., decision-making involvement, conflict, economic investments) have little effect on loyalty and exit. The findings question the utility of hospital strategies to improve the climate of physician-hospital relations, and suggest several qualifications for research on the commitment of professionals.