Antecedents and Outcomes of Physician Coworker Conflict: A Differential Occupational Model for Health Care Managers

Interpersonal conflict between physicians and their coworkers hinders health care organizations today on an unprecedented scale. Most research on physician conflict has been restricted to 2 occupational groups, nurses and administrators. Yet as health care delivery becomes more complex and interdependent, physician interpersonal conflict impacts all occupational groups. Thus, we seek to provide health care managers with specific guidance about how they might eliminate negative effects of physician-related interpersonal conflict for each occupation.

We examined antecedents and outcomes of physician conflict across 4 occupational groups (office clerical and support staff, professional and technical, nursing, and managerial) in a survey of 1451 US health care employees. Using Multigroup Structural Equations Modeling (MSEM) analysis we estimated each relationship in our model across the 4 occupational groups.

We found that workload, perceived HR climate and patient-related incentives predicted physician conflict, and that physician conflict related to burnout, intention to turn over and psychological safety. Most notably, these antecedents and outcomes varied meaningfully across occupational groups.

These observed differential effects in our results suggest that managers should carefully consider the needs of different occupational groups separately when designing and implementing interventions to prevent and ameliorate physician conflict. In short, the antecedents and outcomes of physician conflict are different for office/clerical, nurses, professional/technical employees, and management groups and therefore require different solutions. In short, it behooves health care organizations to avoid a one size fits all approach to improving workplace relationships.