title: Doctor-patient relationships (DPR) in China.
abstract: Purpose The 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/approach Using 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. Findings Commitment 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 implications DPR 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/value This 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.
authors.affiliation: Instituto Universitario de Lisboa (ISCTE-IUL) , Business Research Unit (UNIDE-IUL), Lisbon, Portugal.
authors.forename: Shaozhuang
authors.identifier: http://orcid.org/0000-0002-2199-1400
authors.initials: S
authors.lastname: Ma
authors.affiliation: Third Affiliated Hospital of Guangzhou Medical University , Guangzhou, China.
authors.forename: Xuehu
authors.initials: X
authors.lastname: Xu
authors.affiliation: Instituto Universitario de Lisboa (ISCTE-IUL) , Business Research Unit (UNIDE-IUL), Lisbon, Portugal.
authors.forename: Virginia
authors.initials: V
authors.lastname: Trigo
authors.affiliation: Instituto Universitario de Lisboa (ISCTE-IUL) , Business Research Unit (UNIDE-IUL), Lisbon, Portugal.
authors.forename: Nelson J C
authors.initials: NJ
authors.lastname: Ramalho
mesh_terms: D001291:Attitude of Health Personnel; D002681:China; D003430:Cross-Sectional Studies; D006739:Hospital Administration; D006740:Hospital Administrators; D006801:Humans; D007588:Job Satisfaction; D010817:Physician-Patient Relations; D058996:Quality Improvement; D011795:Surveys and Questionnaires
keywords: China; Chinese hospitals; Commitment HR practices; DPR; Doctor-patient relationship; Doctors; Healthcare reform in China; Hospital management; Hospital violence; Human resource management; Job satisfaction; Patients