Study On Organizational Cultural Impacts Of Hospitals Upon Doctor’s Professional Independence

Doctors are asked to heal patients on behalf of patients, and the doctor’sprofessionalism required that diagnosis is not affected by external factors and doctors’own interests. With market economy development and the advancement of health carereform, doctors’ professionalism gradually sinking, which corrupt the medical ethics.How to advocate for the doctor’s professionalism has become the problem currenthospital reform urgently to solve.Doctor professional independence refers to that doctor practice "Hippocratic oath"throughout his career, which diagnose patients by their professional judgment ratherthan external factors. Hospital reform make great changes in the structure of the hospital,which redefine the relationship between the doctors and managers; With hospitalstructure changing the hospital organizational culture take transformation, whichimpacts on doctors embedded in the organization and threatens the doctor professionalindependence.This paper firstly review the professionalism, hospital culture and doctorprofessional commitment, and doctor-manager relationship relative literatures. Based onprevious researches, the paper build a theory on mechanism of hospital cultureinfluences the doctor professional independence. The doctor professional commitment,doctor-managers target consistency and power balance play intermediary roles in thehospital organization culture influence the professional independence. The paper teststwo different oriented hospital organizational culture (administrative orientation andmarket orientation) roles in the theoretical model, and puts forward the correspondingtheoretical assumptions to test.The paper empirically tests the theoretical model by the questionnaire method. Theinvestigating units including three big first-class hospitals:(The first affiliated hospital,Sun Yat-sen University the Second Affiliated Hospital of GuangZhou MedicalUniversity Guangzhou First People’s Hospital. I collects a total of491questionnaires in38departments. The paper uses descriptive statistics and structural equation model toanalyze data by LISERL and SPSS. The results are: Administrative hospital organizational culture produces negative effect to thepower balance between doctors and managers, and the balance of power positivelyimpacts on doctors professional independence; so the power balance plays a negativeintermediary role in the relationship between administrative hospital organizationculture and doctors’ professional independence. Market-oriented hospital organizationalculture produces positive effect to the power balance between doctors and managers,and the balance of power positively impacts on doctors’ professional independence; sothe power balance plays a positive intermediary role in the relationship betweenmarket-oriented organizational hospital culture and doctors’ professional independence.Market-oriented hospital organizational culture produces positive effect to the doctorprofessional commitment, and doctor professional commitment positively impacts ondoctors’ professional independence; so the doctor professional commitment plays apositive intermediary role in the relationship between market-oriented organizationalhospital culture and doctors’ professional independence.