The importance of clinical leadership for organisational commitment: Evidence from a survey among Norwegian hospital physicians

The concept of organisational commitment has been variably and extensively defined, measured and researched for several decades. In short, organisational commitment is said to be an employee’s psychological attachment to the organisation. The organisational climate of a hospital is important for obvious reasons: the performance of the hospital is affected by it; it relates to the employee’s commitment to the organisation, and thereby their willingness and motivation to put in the extra effort in their work tasks. Dedicated and committed employees are likely to enhance the performance of a hospital, while the lack of such may impact negatively on patient care. In particular, there is a growing interest in the role of clinical leadership for hospital performance, as well as for employee attitudes and well-being. This paper investigates how clinical leadership affects the organisational climate in hospitals. More specifically, the paper tests how different leadership styles affect the organisational commitment of hospital physicians. Is for instance a leadership style that is perceived to emphasise the promotion of professional standards and quality in patient treatment positively related to commitment, while a leadership style associated with economic management and budgetary control will work in the opposite direction? Combining a survey among 2500 hospital physicians in 2006 with data on hospital organisation and activity, I employ multi-level techniques to control for a number of other individual and hospital-specific factors that may influence the organisational climate in the hospitals. The individual-level control-variables incorporated in the empirical model in addition to leadership style are age, gender, professional position, share of patient-related working time, and medical speciality, while three hospital-specific variables are introduced, reflecting patient-mix, size and efficiency. In addition, the analysis also controls for the role of geography.