Health care institutions, medical organizing, and physicians: A multilevel analysis

Managed care---the dominant mode of health care organizing and financing today---may threaten physicians' satisfaction with practicing medicine, but research has revealed that it is not dissatisfying for physicians in all organizational settings. The institutional theory of organizational communication (ITOC) offers a multileveled explanation of physicians' reactions to managed care based on their institutional identifications and communication with managed care organizations. A multileveled analysis of data from physicians (n = 1,049) in practices (n = 492) investigates this explanation. The results suggest that institutional identifications moderate the relationship between the experience of managed care and physician satisfaction, and offer evidence for the importance of the communication between managed care representatives and physicians. The results also provide an example of the applicability of multilevel modeling for organizational and health communication research.