title: Factors affecting physician loyalty and exit: a longitudinal analysis of physician-hospital relationships.
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.
authors.affiliation: Department of Management and Policy, College of Business and Public Administration, University of Arizona, Tucson 85721.
authors.forename: L R
authors.initials: LR
authors.lastname: Burns
authors.forename: D R
authors.initials: DR
authors.lastname: Wholey
mesh_terms: D000367:Age Factors; D001291:Attitude of Health Personnel; D001519:Behavior; D003258:Consumer Behavior / Q000706:statistics & numerical data; D006766:Hospitals, County / Q000706:statistics & numerical data*; D006801:Humans; D016018:Least-Squares Analysis; D008137:Longitudinal Studies; D010343:Patient Admission / Q000706:statistics & numerical data*; D010558:Personnel Loyalty; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D011593:Psychology, Social; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014481:United States