Skip to main content
Top
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Hospital-physician relations: the relative importance of economic, relational and professional attributes to organizational attractiveness

Authors: Jeroen Trybou, Paul Gemmel, Yves Van Vaerenbergh, Lieven Annemans

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

Belgian hospitals face a growing shortage of physicians and increasingly competitive market conditions. In this challenging environment hospitals are struggling to build effective hospital-physician relationships which are considered to be a critical determinant of organizational success.

Methods

Employed physicians of a University hospital were surveyed. Organizational attributes were identified through the literature and two focus groups. Variables were measured using validated questionnaires. Descriptive analyses and linear regression were used to test the model and relative importance analyses were performed.

Results

The selected attributes predict hospital attractiveness significantly (79.3%). The relative importance analysis revealed that hospital attractiveness is most strongly predicted by professional attributes (35.3%) and relational attributes (29.7%). In particular, professional development opportunities (18.8%), hospital prestige (16.5%), organizational support (17.2%) and leader support (9.3%) were found to be most important. Besides these non-economic aspects, the employed physicians indicated pay and financial benefits (7.4%) as a significant predictor of hospital attractiveness. Work-life balance and job security were not significantly related to hospital attractiveness.

Conclusions

This study shows that initiatives aimed at strengthening physicians’ positive perceptions of professional and relational aspects of practicing medicine in hospitals, while assuring satisfactory financial conditions, may offer useful avenues for increasing the level of perceived hospital attractiveness. Overall, hospitals are advised to use a differentiated approach to increase their attractiveness to physicians.
Appendix
Available only for authorised users
Literature
1.
go back to reference Berenson RA, Bodenheimer T, Pham HH: Specialty-service lines: Salvos in the new medical arms race. Health Aff. 2006, 25 (5): 337-343. 10.1377/hlthaff.25.w337.CrossRef Berenson RA, Bodenheimer T, Pham HH: Specialty-service lines: Salvos in the new medical arms race. Health Aff. 2006, 25 (5): 337-343. 10.1377/hlthaff.25.w337.CrossRef
2.
go back to reference Al-Amin M, Housman M: Ambulatory surgery center and general hospital competition: entry decisions and strategic choices. Health Care Manage Rev. 2012, 37 (3): 223-234. 10.1097/HMR.0b013e318235ed31.CrossRefPubMed Al-Amin M, Housman M: Ambulatory surgery center and general hospital competition: entry decisions and strategic choices. Health Care Manage Rev. 2012, 37 (3): 223-234. 10.1097/HMR.0b013e318235ed31.CrossRefPubMed
3.
go back to reference Cooper RA, Getzen TA, Mckee HJ, Laud P: Economic and demographic trends signal an impending physician shortage. Health Aff. 2002, 21 (1): 140-154. 10.1377/hlthaff.21.1.140.CrossRef Cooper RA, Getzen TA, Mckee HJ, Laud P: Economic and demographic trends signal an impending physician shortage. Health Aff. 2002, 21 (1): 140-154. 10.1377/hlthaff.21.1.140.CrossRef
4.
go back to reference Kirch DG, Mackenzie KH, Dill MJ: Physician workforce projections in an Era of health care reform. Annu Rev Med. 2012, 63: 435-445. 10.1146/annurev-med-050310-134634.CrossRefPubMed Kirch DG, Mackenzie KH, Dill MJ: Physician workforce projections in an Era of health care reform. Annu Rev Med. 2012, 63: 435-445. 10.1146/annurev-med-050310-134634.CrossRefPubMed
5.
go back to reference Martin JJM, Gonzalez M, Garcia MDC: Review of the literature on the determinants of healthcare expenditure. Appl Econ. 2011, 43 (1): 19-46. 10.1080/00036841003689754.CrossRef Martin JJM, Gonzalez M, Garcia MDC: Review of the literature on the determinants of healthcare expenditure. Appl Econ. 2011, 43 (1): 19-46. 10.1080/00036841003689754.CrossRef
6.
go back to reference von Knorring M, de Rijk A, Alexanderson K: Managers’ perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare. BMC Health Serv Res. 2010, 10: 271-10.1186/1472-6963-10-271.CrossRefPubMedPubMedCentral von Knorring M, de Rijk A, Alexanderson K: Managers’ perceptions of the manager role in relation to physicians: a qualitative interview study of the top managers in Swedish healthcare. BMC Health Serv Res. 2010, 10: 271-10.1186/1472-6963-10-271.CrossRefPubMedPubMedCentral
7.
go back to reference Kaissi A: Manager-physician relationships: an organizational theory perspective. Health Care Manag. 2005, 24 (2): 165-176. Kaissi A: Manager-physician relationships: an organizational theory perspective. Health Care Manag. 2005, 24 (2): 165-176.
8.
go back to reference Cortese D, Smoldt R: Taking steps toward integration. Health Aff. 2007, 26 (1): 68-71. 10.1377/hlthaff.26.1.w68.CrossRef Cortese D, Smoldt R: Taking steps toward integration. Health Aff. 2007, 26 (1): 68-71. 10.1377/hlthaff.26.1.w68.CrossRef
9.
go back to reference Goes JB, Zhan C: The effects of hospital-physician integration strategies on hospital financial performance. Health Serv Res. 1995, 30 (4): 507-530.PubMedPubMedCentral Goes JB, Zhan C: The effects of hospital-physician integration strategies on hospital financial performance. Health Serv Res. 1995, 30 (4): 507-530.PubMedPubMedCentral
10.
go back to reference Safavi K: Aligning financial incentives. J Healthc Manage. 2006, 51 (3): 146-151. Safavi K: Aligning financial incentives. J Healthc Manage. 2006, 51 (3): 146-151.
11.
go back to reference Trybou J, Gemmel P, Annemans L: The ties that bind: an integrative framework of physician-hospital alignment. BMC Health Serv Res. 2011, 11: 36-10.1186/1472-6963-11-36.CrossRefPubMedPubMedCentral Trybou J, Gemmel P, Annemans L: The ties that bind: an integrative framework of physician-hospital alignment. BMC Health Serv Res. 2011, 11: 36-10.1186/1472-6963-11-36.CrossRefPubMedPubMedCentral
12.
go back to reference Chapman DS, Uggerslev KL, Carroll SA, Piasentin KA, Jones DA: Applicant attraction to organizations and job choice: A meta-analytic review of the correlates of recruiting outcomes. J Appl Psychol. 2005, 90 (5): 928-944.CrossRefPubMed Chapman DS, Uggerslev KL, Carroll SA, Piasentin KA, Jones DA: Applicant attraction to organizations and job choice: A meta-analytic review of the correlates of recruiting outcomes. J Appl Psychol. 2005, 90 (5): 928-944.CrossRefPubMed
13.
go back to reference Lievens F, Van Hoye G, Schreurs B: Examining the relationship between employer knowledge dimensions and organizational attractiveness: an application in a military context. J Occup Organ Psych. 2005, 78 (4): 553-572. 10.1348/09631790X26688.CrossRef Lievens F, Van Hoye G, Schreurs B: Examining the relationship between employer knowledge dimensions and organizational attractiveness: an application in a military context. J Occup Organ Psych. 2005, 78 (4): 553-572. 10.1348/09631790X26688.CrossRef
14.
go back to reference Mascia D, Di Vincenzo F: Understanding hospital performance: the role of network ties and patterns of competition. Health Care Manage Rev. 2011, 36 (4): 327-337. 10.1097/HMR.0b013e31821fa519.CrossRefPubMed Mascia D, Di Vincenzo F: Understanding hospital performance: the role of network ties and patterns of competition. Health Care Manage Rev. 2011, 36 (4): 327-337. 10.1097/HMR.0b013e31821fa519.CrossRefPubMed
15.
go back to reference Frandsen S: Organizational image, identification, and cynical distance: prestigious professionals in a low-prestige organization. Manage Commun Q. 2012, 26 (3): 351-376. 10.1177/0893318912438692.CrossRef Frandsen S: Organizational image, identification, and cynical distance: prestigious professionals in a low-prestige organization. Manage Commun Q. 2012, 26 (3): 351-376. 10.1177/0893318912438692.CrossRef
16.
go back to reference Hekman DR, Bigley GA, Steensma HK, Hereford JF: Combined effects of organizational and professional identification on the reciprocity dynamic for professional employees. Acad Manage J. 2009, 52 (3): 506-526. 10.5465/AMJ.2009.41330897.CrossRef Hekman DR, Bigley GA, Steensma HK, Hereford JF: Combined effects of organizational and professional identification on the reciprocity dynamic for professional employees. Acad Manage J. 2009, 52 (3): 506-526. 10.5465/AMJ.2009.41330897.CrossRef
17.
go back to reference Burns LR, Muller RW: Hospital-physician collaboration: landscape of economic integration and impact on clinical integration. Milbank Q. 2008, 86 (3): 375-434. 10.1111/j.1468-0009.2008.00527.x.CrossRefPubMedPubMedCentral Burns LR, Muller RW: Hospital-physician collaboration: landscape of economic integration and impact on clinical integration. Milbank Q. 2008, 86 (3): 375-434. 10.1111/j.1468-0009.2008.00527.x.CrossRefPubMedPubMedCentral
18.
go back to reference Trybou J, Gemmel P, Annemans L: How to govern physician-hospital exchanges: contractual and relational issues in Belgian hospitals. J Health Serv Res Policy. 2014, doi:10.1177/1355819613518765 Trybou J, Gemmel P, Annemans L: How to govern physician-hospital exchanges: contractual and relational issues in Belgian hospitals. J Health Serv Res Policy. 2014, doi:10.1177/1355819613518765
19.
go back to reference Bunderson J: How work ideologies shape the psychological contracts of professional employees: doctors’ responses to perceived breach. J Organ Behav. 2001, 22 (7): 717-741. 10.1002/job.112.CrossRef Bunderson J: How work ideologies shape the psychological contracts of professional employees: doctors’ responses to perceived breach. J Organ Behav. 2001, 22 (7): 717-741. 10.1002/job.112.CrossRef
20.
21.
go back to reference Rousseau DM: Psychological and implied contracts in organization. Empl %ities Rights J. 1989, 2 (2): 121-139. 10.1007/BF01384942.CrossRef Rousseau DM: Psychological and implied contracts in organization. Empl %ities Rights J. 1989, 2 (2): 121-139. 10.1007/BF01384942.CrossRef
22.
go back to reference Coyle-Shapiro JAM, Conway N: Exchange relationships: examining psychological contracts and perceived organizational support. J Appl Psychol. 2005, 90 (4): 774-781.CrossRefPubMed Coyle-Shapiro JAM, Conway N: Exchange relationships: examining psychological contracts and perceived organizational support. J Appl Psychol. 2005, 90 (4): 774-781.CrossRefPubMed
23.
go back to reference Albert S, Ashforth BE, Dutton JE: Organizational identity and identification: charting new waters and building new bridges. Acad Manage Rev. 2000, 25 (1): 13-24a. 10.5465/AMR.2000.2791600. 14CrossRef Albert S, Ashforth BE, Dutton JE: Organizational identity and identification: charting new waters and building new bridges. Acad Manage Rev. 2000, 25 (1): 13-24a. 10.5465/AMR.2000.2791600. 14CrossRef
24.
go back to reference Dukerich JM, Golden BR, Shortell SM: Beauty is in the eye of the beholder: the impact of organizational identification identity and image on the cooperative behaviors of physicians. Admini Sci Quart. 2002, 47 (3): 507-553. 10.2307/3094849.CrossRef Dukerich JM, Golden BR, Shortell SM: Beauty is in the eye of the beholder: the impact of organizational identification identity and image on the cooperative behaviors of physicians. Admini Sci Quart. 2002, 47 (3): 507-553. 10.2307/3094849.CrossRef
25.
go back to reference Ghoshal S, Moran P: Bad for practice: a critique of the transaction cost theory. Acad Manage Rev. 1996, 21 (1): 13-47. Ghoshal S, Moran P: Bad for practice: a critique of the transaction cost theory. Acad Manage Rev. 1996, 21 (1): 13-47.
26.
go back to reference Granovetter M: Economic action and social structure: the problem of embeddedness. Am J Sociol. 1985, 91 (3): 481-510. 10.1086/228311.CrossRef Granovetter M: Economic action and social structure: the problem of embeddedness. Am J Sociol. 1985, 91 (3): 481-510. 10.1086/228311.CrossRef
27.
go back to reference Kunz AH, Pfaff D: Agency theory, performance evaluation, and the hypothetical construct of intrinsic motivation. Account Org Soc. 2002, 27 (3): 275-295. 10.1016/S0361-3682(01)00031-9.CrossRef Kunz AH, Pfaff D: Agency theory, performance evaluation, and the hypothetical construct of intrinsic motivation. Account Org Soc. 2002, 27 (3): 275-295. 10.1016/S0361-3682(01)00031-9.CrossRef
28.
go back to reference Edwards MR: An integrative review of employer branding and OB theory. Pers Rev. 2009, 39 (1): 5-23.CrossRef Edwards MR: An integrative review of employer branding and OB theory. Pers Rev. 2009, 39 (1): 5-23.CrossRef
29.
go back to reference Dulac T, Coyle-Shapiro JAM, Henderson DJ, Wayne SJ: Not all responses to breach are the same: the interconnection of social exchange and psychological contract processes in organizations. Acad Manage J. 2008, 51 (6): 1079-1098. 10.5465/AMJ.2008.35732596.CrossRef Dulac T, Coyle-Shapiro JAM, Henderson DJ, Wayne SJ: Not all responses to breach are the same: the interconnection of social exchange and psychological contract processes in organizations. Acad Manage J. 2008, 51 (6): 1079-1098. 10.5465/AMJ.2008.35732596.CrossRef
30.
go back to reference Trybou J, Gemmel P, Pauwels Y, Henninck C, Clays E: The impact of organizational support and leader–member exchange on the work-related behaviour of nursing professionals: the moderating effect of professional and organizational identification. J Adv Nurs. 2014, 70 (2): 373-382. 10.1111/jan.12201.CrossRefPubMed Trybou J, Gemmel P, Pauwels Y, Henninck C, Clays E: The impact of organizational support and leader–member exchange on the work-related behaviour of nursing professionals: the moderating effect of professional and organizational identification. J Adv Nurs. 2014, 70 (2): 373-382. 10.1111/jan.12201.CrossRefPubMed
31.
go back to reference Beauregard TA: Making the link between work-life balance practices and organizational performance. Hum Resour Manage R. 2009, 19 (1): 9-22. 10.1016/j.hrmr.2008.09.001.CrossRef Beauregard TA: Making the link between work-life balance practices and organizational performance. Hum Resour Manage R. 2009, 19 (1): 9-22. 10.1016/j.hrmr.2008.09.001.CrossRef
32.
go back to reference Bunderson JS, Lofstrom SM, Van De Ven AH: Conceptualizing and measuring professional and administrative models of organizing. Organ Res Methods. 2000, 3 (4): 366-391. 10.1177/109442810034004.CrossRef Bunderson JS, Lofstrom SM, Van De Ven AH: Conceptualizing and measuring professional and administrative models of organizing. Organ Res Methods. 2000, 3 (4): 366-391. 10.1177/109442810034004.CrossRef
33.
go back to reference Highhouse S, Lievens F, Sinar EF: Measuring attraction to organizations. Edu Psychol Meas. 2003, 63 (6): 986-1001. 10.1177/0013164403258403.CrossRef Highhouse S, Lievens F, Sinar EF: Measuring attraction to organizations. Edu Psychol Meas. 2003, 63 (6): 986-1001. 10.1177/0013164403258403.CrossRef
34.
go back to reference Morgan DL: The Focus Group Kit. Planning Focus Groups. 1998, California: Thoasand Oaks: Sage PublicationsCrossRef Morgan DL: The Focus Group Kit. Planning Focus Groups. 1998, California: Thoasand Oaks: Sage PublicationsCrossRef
35.
go back to reference Lievens F, Highhouse S: The relation of instrumental and symbolic attributes to a company’s attractiveness as an employer. Pers Psychol. 2003, 56 (1): 75-102. 10.1111/j.1744-6570.2003.tb00144.x.CrossRef Lievens F, Highhouse S: The relation of instrumental and symbolic attributes to a company’s attractiveness as an employer. Pers Psychol. 2003, 56 (1): 75-102. 10.1111/j.1744-6570.2003.tb00144.x.CrossRef
36.
go back to reference Faul F, Erdfelder E, Buchner A, Lang AG: Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009, 41 (4): 1149-1160. 10.3758/BRM.41.4.1149.CrossRefPubMed Faul F, Erdfelder E, Buchner A, Lang AG: Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009, 41 (4): 1149-1160. 10.3758/BRM.41.4.1149.CrossRefPubMed
37.
go back to reference Darlington RB: Multiple regression in psychological research and practice. Psychol Bull. 1968, 69 (3): 161-182.CrossRefPubMed Darlington RB: Multiple regression in psychological research and practice. Psychol Bull. 1968, 69 (3): 161-182.CrossRefPubMed
38.
go back to reference Johnson JW: A heuristic method for estimating the relative weight of predictor variables in multiple regression. Multivar Behav Res. 2000, 35 (1): 1-19. 10.1207/S15327906MBR3501_1.CrossRef Johnson JW: A heuristic method for estimating the relative weight of predictor variables in multiple regression. Multivar Behav Res. 2000, 35 (1): 1-19. 10.1207/S15327906MBR3501_1.CrossRef
39.
go back to reference Templeton L, Deehan A, Taylor C, Drummond C, Strang J: Surveying general practitioners: does a low response rate matter?. Brit J Gen Practice. 1997, 47 (415): 91-94. Templeton L, Deehan A, Taylor C, Drummond C, Strang J: Surveying general practitioners: does a low response rate matter?. Brit J Gen Practice. 1997, 47 (415): 91-94.
40.
go back to reference Coyle-Shapiro JAM, Shore L, Taylor M, Tetrick L: The Employment Relationship: Examining Psychological and Contextual Perspectives. 2010, Oxford: Oxford University Express Coyle-Shapiro JAM, Shore L, Taylor M, Tetrick L: The Employment Relationship: Examining Psychological and Contextual Perspectives. 2010, Oxford: Oxford University Express
41.
go back to reference Trybou J, De Pourcq K, Paeshuyse M, Gemmel P: The importance of social exchange to nurses and nursing assistants: impact on retention factors. J Nurs Manage. 2013, doi:10.1111/jonm.12039 Trybou J, De Pourcq K, Paeshuyse M, Gemmel P: The importance of social exchange to nurses and nursing assistants: impact on retention factors. J Nurs Manage. 2013, doi:10.1111/jonm.12039
42.
go back to reference Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM: Mental health of hospital consultants: the effect of stress and satisfaction at work. Lancet. 1996, 16 (347): 724-728.CrossRef Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM: Mental health of hospital consultants: the effect of stress and satisfaction at work. Lancet. 1996, 16 (347): 724-728.CrossRef
43.
go back to reference Herzberg F: Work and the Nature of Man. 1966, Cleveland: World Publishing Herzberg F: Work and the Nature of Man. 1966, Cleveland: World Publishing
Metadata
Title
Hospital-physician relations: the relative importance of economic, relational and professional attributes to organizational attractiveness
Authors
Jeroen Trybou
Paul Gemmel
Yves Van Vaerenbergh
Lieven Annemans
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-232

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue