Abstract
PurposeThe purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals’ job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways.Design/methodology/approachUsing a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study.FindingsCommitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers’ main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only.Practical implicationsDPR might be improved by applying commitment HR practices to increase healthcare professional’s intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects’ expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements.Originality/valueThis study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations among commitment HR practices, job satisfaction and DPR in the Chinese healthcare sector. The findings provide evidence to support the value of commitment HR practices in Chinese hospital context, and demonstrate the importance of effective HRM in improving both hospital managers and clinicians’ work attitudes.
Highlights
IntroductionChina’s healthcare system has been employing a medical model based on specialized department consultation in hospitals that originated in the former Soviet Union
AND THEORETICAL FRAMEWORKChinese Healthcare Reforms and Doctor-Patient RelationshipHealthcare Reforms (1980s-Present)Along with China’s opening up policy at the end of 1970s, Chinese healthcare system has experienced two major phases of reform: the first round is market-oriented reforms from the early 1980s to 2002, and the second round is comprehensive reforms from 2003 to the present (WHO, 2015).Generally speaking, China’s healthcare system has been employing a medical model based on specialized department consultation in hospitals that originated in the former Soviet Union
The model indicates a reversal on the strongest path linking job satisfaction and doctorpatient relationships (DPR) whereby managers’ main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic job satisfaction only
Summary
China’s healthcare system has been employing a medical model based on specialized department consultation in hospitals that originated in the former Soviet Union. Applied in the Second World War, this medical model of specialized practice is suitable for wartime as it encourages piecemeal and adhoc treatment solutions (Li, 2012), but cannot respond neither to basic healthcare services nor to higher demands of a growing number of affluent population. The success of general practice (or family medicine) in Western countries inspired the Chinese government to introduce it as part of the reforms encouraging patients with minor illnesses to address community hospitals for this consultation mode, and in 2006 the Ministry of Health launched a pilot residency project for different specialties including general practice (Zhang, 2007). There is insufficient knowledge of the subject and shortage of quality professionals in the field; as a consequence large hospitals are severely overcrowded while community hospitals are underutilized
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