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Article
Publication date: 10 June 2021

Sergio Riotta and Manfredi Bruccoleri

This study formulates a new archetypical model that describes and re-interprets the patient–physician relationship from the perspective of two widespread phenomena in the…

Abstract

Purpose

This study formulates a new archetypical model that describes and re-interprets the patient–physician relationship from the perspective of two widespread phenomena in the healthcare delivery process: value co-creation (VCC) and defensive medicine (DM).

Design/methodology/approach

Grounded in the existing literature on VCC and DM, the authors designed and conducted 20 in-depth interviews with doctors (and patients) about their past relationships with patients (and doctors). After putting the recorded interviews through qualitative analysis with a three-level coding activity, the authors built an empirically informed model to classify patient–physician relationships.

Findings

The authors identified four archetypes of patient–physician relationships. Each archetype is described along with its representing characteristics and explained in terms of its consequences as they relate to VCC and DM.

Research limitations/implications

This research contributes to the literature on both VCC in healthcare and DM, in addition to the patient–physician's relationship literature.

Practical implications

Being aware of patient–physician relationship mechanics, building long-term relations with patients and investing in service personalization and patient-centred care can effectively mitigate the risks of DM behaviours on one side while increasing the likelihood of VCC actualization on the other.

Originality/value

Although strictly linked to the interactions between patients and doctors, VCC and DM are typically considered disentangled. In this research paper, the authors identified four archetypes of patient–physician relationships in relation to these two phenomena.

Details

Journal of Service Theory and Practice, vol. 31 no. 6
Type: Research Article
ISSN: 2055-6225

Keywords

Article
Publication date: 4 September 2017

Minna Matikainen, Leena Olkkonen, Nina Katajavuori, Petri Parvinen and Anne Juppo

This study aims to examine the attitudes of physicians towards the pharmaceutical industry and investigates how these are reflected when a new drug is introduced.

Abstract

Purpose

This study aims to examine the attitudes of physicians towards the pharmaceutical industry and investigates how these are reflected when a new drug is introduced.

Design/methodology/approach

The qualitative theme-interview study adopts the innovation diffusion perspective and is conducted with 22 general practitioners and specialists.

Findings

Physicians’ positive relationship orientation and active interaction can result in early adoption of new drugs with product advantage. In comparison, negatively oriented and passively interacting physicians will adopt a new drug later based on research evidence- and experience-based reasoning and opinions of their colleagues.

Research limitations/implications

The objective was to obtain a deeper understanding of the research themes. Further qualitative studies in different countries and health care environments with a larger sample size would improve generalizability of results.

Practical implications

It’s necessary to find an optimal win – win situation that fulfils both parties’ needs, while decreasing unnecessary and time-consuming marketing activities and avoiding waste of limited resources and allowing physicians to participate in activities that better serve their primary needs. Managers in pharmaceutical companies should ensure their sales representatives act in appropriate and professional ways, interact openly and reciprocally and provide accurate and objective information.

Originality/value

The study demonstrates that the physician–pharmaceutical industry relationship has developed from being ethically precarious and having non-professional related personal benefits, towards becoming a more sustainable collaboration. The mutually beneficial collaboration supports physicians’ professional development, enabling better patient care and relieving strain on limited resources.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 11 no. 3
Type: Research Article
ISSN: 1750-6123

Keywords

Book part
Publication date: 10 February 2010

Jane Cote and Claire Kamm Latham

Building on prior research linking stakeholder relationship quality with financial performance, we explore interorganizational engagement from a bilateral perspective, more fully…

Abstract

Building on prior research linking stakeholder relationship quality with financial performance, we explore interorganizational engagement from a bilateral perspective, more fully representing the dynamics within an alliance. Interorganizational relationship quality and stakeholder management theory in healthcare and in accounting research provide the foundation for these insights.

While the study's findings demonstrate consistent views regarding the importance of relationship management and patient care, the two stakeholder groups hold divergent perspectives on how to accomplish these goals. Insurance executives take a population perspective, whereas physician practices focus their decision making at the patient level. The relative power and size between stakeholders was instrumental in how insurers chose to develop relationships with individual physician practices. These findings provide the nucleus for understanding reported frictions.

Details

Advances in Management Accounting
Type: Book
ISBN: 978-1-84950-755-4

Book part
Publication date: 11 August 2014

Gregory W. Stevens

This chapter proposes a paradigm shift in considering the collective identification of employed physicians and how it influences physician engagement.

Abstract

Purpose

This chapter proposes a paradigm shift in considering the collective identification of employed physicians and how it influences physician engagement.

Design/methodology/approach

There are many challenges for organizations employing physicians, particularly in terms of engagement in organizational initiatives. Prior research suggests this conflict stems from how physicians think of themselves as professionals versus employees (as forms of collective identification). Unfortunately, research is limited in addressing these dynamics.

Findings

This conceptual chapter considers the complex network of relationships that physicians perceive between the collectives to which they belong. A primary collective identification (i.e., the profession) is proposed to influence subsequent collective identification (i.e., the organization), and that these meanings and relationships along with contextual factors drive engagement.

Originality/value

Health care organizations increasingly rely on engagement from their physicians to improve upon coordinated care. This proposed conceptualization offers new insight into the dynamics surrounding how and why employed physicians become engaged.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

Keywords

Article
Publication date: 3 October 2019

Hala Ahmadieh, Ghali H. Majzoub, Faraj M. Abou Radi and Areej H. Abou Baraki

A physician–nurse relationship is a complex, professional and shared-decision-making process, which is an important predictor of high-quality patient care. The purpose of this…

Abstract

Purpose

A physician–nurse relationship is a complex, professional and shared-decision-making process, which is an important predictor of high-quality patient care. The purpose of this paper is to explore the attitude of the physician–nurse relationship in Southern Lebanon hospitals.

Design/methodology/approach

A descriptive institutional cross-sectional study was conducted among different departments of three hospitals in Southern Lebanon using a validated Jefferson Scale of Attitude.

Findings

In sum, 89 physicians and 245 nurses accepted to participate. The nurses’ mean age was 32 and the physicians’ was 44. The mean score was found to be 46 for all participants, with significantly higher scores noted among nurses compared to physicians (48 vs 43, respectively) and higher scores among females compared to males (48 vs 46, respectively). However, the study scored no significant difference in relation to the degrees attained by nurses and the participants’ years of experience. The majority had agreed that the shortage in the nurses’ staff affects proper patient care delivery. One fourth of the physicians disagreed that nurses should be considered as a collaborator and colleague. Therefore, more work is required to improve this collaboration.

Research limitations/implications

There is a complex relationship normally displayed by physicians and nurses, which cannot be easily interpreted and analyzed. Physicians and nurses may have given socially desirable responses while filling the questionnaire. Even more, this study was conducted in Hospitals in Southern Lebanon, and it would be nice to extend this study to include further hospitals in other regions in Lebanon as well.

Practical implications

Nurses had higher scores toward collaboration, with females scoring higher than males. However, overall scores are considered to be lower compared to other countries. Thus, more efforts should be done on improving this communication among nurses and physicians, through promoting inter-professional undergraduate and postgraduate education training toward more effective communication.

Social implications

Quality of patient care would be improved if more work is done on improving the collaboration between physicians and nurses, and this was shown to be required as per study results.

Originality/value

There is a gap in literature assessing this important topic which is the collaboration and attitude of nurses and physicians toward their relationship in Lebanon. It is extremely important that efforts should be taken in order to determine the type of nurse–physician relationship in every local context as this relationship affects quality of patients’ care.

Details

International Journal of Health Governance, vol. 25 no. 1
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 1 September 2006

Robyn Ouschan, Jillian Sweeney and Lester Johnson

Several trends such as improved access to health care information via the internet, the growth of self‐help groups and expenditure on alternative medicine signals consumers are…

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Abstract

Purpose

Several trends such as improved access to health care information via the internet, the growth of self‐help groups and expenditure on alternative medicine signals consumers are taking an active role in their own health management. Chronic illnesses such as diabetes and asthma require a significant amount of self‐management and thus call for a collaborative patient‐physician relationship. This study explores whether empowering patient‐physician consultations measured through three patient empowerment dimensions (patient control, patient participation, physician support) enhance patients trust in and commitment to their physician.

Design/methodology/approach

A comprehensive mail survey of adults registered with one of four different chronic illness associations in Australia was conducted to collect the data.

Findings

The structural equation modelling results show that patients are more trusting of and committed to physicians who adopt an empowering communication style with them.

Research limitations/implications

This study focuses on the Australian healthcare context. Thus, future multinational studies should explore suitable strategies to empower healthcare consumers that build on the constraints placed by diverse healthcare systems.

Practical implications

In a managed health care and cost cutting climate where patient trust is deteriorating, these findings suggest that empowering patients presents a means to improve the patient‐physician relationship.

Originality/value

Whilst numerous marketing scholars have researched the empowerment of staff, there is a shortage of studies that address the meaning and outcomes of consumer empowerment. This study proposes a unique communication based consumer empowerment construct which is shown to impact on consumer‐service provider relationships.

Details

European Journal of Marketing, vol. 40 no. 9/10
Type: Research Article
ISSN: 0309-0566

Keywords

Article
Publication date: 3 July 2023

Fanbo Meng, Yixuan Liu, Xiaofei Zhang and Libo Liu

Effectively engaging patients is critical for the sustainable development of online health communities (OHCs). Although physicians’ general knowledge-sharing, which is free to the…

Abstract

Purpose

Effectively engaging patients is critical for the sustainable development of online health communities (OHCs). Although physicians’ general knowledge-sharing, which is free to the public, represents essential resources of OHCs that have been shown to promote patient engagement, little is known about whether such knowledge-sharing can backfire when superfluous knowledge-sharing is perceived as overwhelming and anxiety-provoking. Thus, this study aims to gain a comprehensive understanding of the role of general knowledge-sharing in OHCs by exploring the spillover effects of the depth and breadth of general knowledge-sharing on patient engagement.

Design/methodology/approach

The research model is established based on a knowledge-based view and the literature on knowledge-sharing in OHCs. Then the authors test the research model and associated hypotheses with objective data from a leading OHC.

Findings

Although counterintuitive, the findings revealed an inverted U-shape relationship between general knowledge-sharing (depth and breadth of knowledge-sharing) and patient engagement that is positively associated with physicians’ number of patients. Specifically, the positive effects of depth and breadth of general knowledge-sharing increase and then decrease as the quantity of general knowledge-sharing grows. In addition, physicians’ offline and online professional status negatively moderated these curvilinear relationships.

Originality/value

This study further enriches the literature on knowledge-sharing and the operations of OHCs from a novel perspective while also offering significant specific implications for OHCs practitioners.

Details

Journal of Knowledge Management, vol. 28 no. 3
Type: Research Article
ISSN: 1367-3270

Keywords

Article
Publication date: 10 October 2016

Tawnya Bosko and Kathryn Wilson

The purpose of this paper is to assess the relationship between patient satisfaction and a variety of clinical quality measures in an ambulatory setting to determine if there is…

Abstract

Purpose

The purpose of this paper is to assess the relationship between patient satisfaction and a variety of clinical quality measures in an ambulatory setting to determine if there is significant overlap between patient satisfaction and clinical quality or if they are separate domains of overall physician quality. Assessing this relationship will help to determine whether there is congruence between different types of clinical quality performance and patient satisfaction and therefore provide insight to appropriate financial structures for physicians.

Design/methodology/approach

Ordered probit regression analysis is conducted with overall rating of physician from patient satisfaction responses to the Clinician and Groups Consumer Assessment of Healthcare Providers and Systems survey as the dependent variable. Physician clinical quality is measured across five composite groups based on 26 Healthcare Effectiveness Data and Information Set (HEDIS) measures aggregated from patient electronic health records. Physician and patient demographic variables are also included in the model.

Findings

Better physician performance on HEDIS measures are correlated with increases in patient satisfaction for three composite measures: antibiotics, generics, and vaccination; it has no relationship for chronic conditions and is correlated with decrease in patient satisfaction for preventative measures, although the negative relationship for preventative measures is not robust in sensitivity analysis. In addition, younger physicians and male physicians have higher satisfaction scores even with the HEDIS quality measures in the regression.

Research limitations/implications

There are four primary limitations to this study. First, the data for the study come from a single hospital provider organization. Second, the survey response rate for the satisfaction measure is low. Third, the physician clinical quality measure is the percent of the physician’s relevant patient population that met the HEDIS measure rather than if the measure was met for the individual patient. Finally, it is not possible to distinguish if the significant coefficient estimates on the physician age and gender variables are capturing systematic differences in physician behavior or capturing patient bias.

Practical implications

The results suggest patient satisfaction and physician clinical quality may be complementary, capturing similar aspects of overall physician quality, across some clinical quality measures but for other measures satisfaction and clinical quality are unrelated or negatively related. Therefore, for some clinical quality metrics, it will be important to separately compensate clinical quality and satisfaction and understand the relationship between metrics. Finally, the strong relationship between the level of patient satisfaction and physician age, physician gender, and patient age are important to consider when designing a physician compensation package based on patient satisfaction; if these differences reflect patient bias they could increase inequality among medical staff if compensation is based on patient satisfaction.

Originality/value

This study is the first to use physician organization data to examine patient satisfaction and physician performance on a variety of HEDIS quality metrics.

Details

Journal of Health Organization and Management, vol. 30 no. 7
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 25 April 2024

Chen Chen and Hong Wu

The advent of online live streaming platforms (OLSPs) and online health communities (OHCs) has expedited the integration of traditional medical services with Internet new media…

Abstract

Purpose

The advent of online live streaming platforms (OLSPs) and online health communities (OHCs) has expedited the integration of traditional medical services with Internet new media technology. Since the practice of physicians conducting live streaming is a relatively new phenomenon, the potential cross-platform effects of such physicians’ live streaming have not received adequate attention.

Design/methodology/approach

This study collected data from 616 physicians specializing in cardiology, obstetrics and gynecology and neurology between April and November 2022 on Live.Baidu.com and WeDoctor.com. It constructed a panel data set comprising a total of 4,928 observations over an 8-month period and validated the model using empirical analysis with the fixed-effects method.

Findings

We find evidence of cross-platform influence in online healthcare. Physicians’ live streaming behavior (whether live or not and the heat of their streams) on OLSPs positively impacts both their consultation and reputation on OHCs. Additionally, physicians’ ability positively moderates the relationships between live streaming heat and their performance (in terms of consultation volume and reputation) on OHCs. However, ability does not moderate the relationship between physicians’ live streaming status (live or not) and their performance (in terms of consultation and reputation) on OHCs. Furthermore, the attractive appearance of the physicians also significantly moderates the impact in a positive way.

Originality/value

This is one of the pioneering studies on physicians’ live streaming. The study offers vital guidance for physicians and patients utilizing dual platforms and holds significant reference value for platform operators (such as OLSPs and OHCs) aiming to optimize platform operations and for the government in policy formulation and industry regulation.

Details

Internet Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1066-2243

Keywords

Article
Publication date: 22 May 2009

A.H.J. Klopper‐Kes, N. Meerdink, W.H. van Harten and C.P.M. Wilderom

The purpose of this paper is to apply the image theory to the hospital context in order to add a perspective into the known complex relationship between physicians and hospital…

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Abstract

Purpose

The purpose of this paper is to apply the image theory to the hospital context in order to add a perspective into the known complex relationship between physicians and hospital managers. This insight can enrich current intervention schemes used in health care to facilitate organisational change.

Design/methodology/approach

In this paper, the image theory of Alexander et al. on the known complex intergroup context of physicians and hospital managers is applied. The theory is operationalised in relative status, power, and goal incompatibility.

Findings

The data show the three variables are highly relevant and representative. Hospital managers see physicians as higher in professional status and power, and having different goals. Physicians see hospital managers to have higher power, lower status, and different goals. The study validates the applicability of the image theory in the Dutch hospital context. This results in a questionnaire suitable for performing a quick scan on the strength and direction of intergroup stereotyping within hospital organisations.

Originality/value

Data from the questionnaire give the opportunity to have insight in the way physicians and hospital managers perceive each other. This insight helps to focus attention on bottlenecks and possibilities in enhancing the co‐operation between physicians and hospital managers. Research on the relationship between physicians and hospital managers is scarce and mostly of a qualitative nature. This paper is executed in both qualitative and quantitative way, which enables us to empirically and statistically validate the data. The resulting questionnaire is applicable on an organisational intergroup level, while the focus in the extant literature is mostly on the interpersonal or intragroup level.

Details

Journal of Health Organization and Management, vol. 23 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

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