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The purpose is to analyse the influence of inertia and group conformity on loyalty in healthcare.

Structural equation model developed from the literature and tested with cross-sectional data from a patient online survey.

Inertia is a significant antecedent of loyalty and has a stronger effect in healthcare than in other service sectors. Group conformity has no significant effect in healthcare.

The strength of the impact of inertia [group conformity] on loyalty depends on the importance of the customer need that the service industry satisfies, in Maslow's hierarchy of needs. Where inertia (stability need) is equally or more [less] important than the customer need, the influence of inertia on loyalty should be positive and strong [weak or insignificant]. In services that satisfy needs more [equally or less] important than group conformity (belonging need), there may be an insignificant [significant] influence of group conformity on customer loyalty, even [especially] in credence services.

Healthcare providers can exploit the stronger effect of inertia in healthcare through development of inertia-based loyalty policies. Regulatory authorities should be vigilant to ensure that these policies are not detrimental to patients. ‘Inert’ patients must become responsible for assessing their loyalties. Authorities and reference groups must stimulate customer loyalty assessments, and assist by providing impartial information.

This is the first study to address the influence of inertia and group conformity on loyalty in the healthcare sector and, from the perspective of Maslow's hierarchy of needs, it is the first to do so in any service sector.