Publication Date

2010-06-08

Availability

Open access

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Interdisciplinary Studies (Graduate)

Date of Defense

May 2010

First Committee Member

Dr. Linda L. Neider - Committee Chair

Second Committee Member

Dr. Steven G. Ullmann - Committee Member

Third Committee Member

Dr. Michael T. French - Committee Member

Fourth Committee Member

Dr. Mark T. O'Connell - Committee Member

Fifth Committee Member

Dr. Chester A. Schriesheim - Committee Member

Abstract

A field study was conducted to investigate patterns of influence used by physicians among a variety of constituents. Specifically, the association between a physicianâ??s use of influence tactics and the level of power of the constituent was examined to offer insights into physician influence and leadership. Preliminary studies identified a listing of the constituents a physician deals with on a routine basis and then the level of power of each of these constituents was investigated. In the main study participants from each of four groups were asked to complete a questionnaire. The groups were selected to include one constituent group from a higher power level than the physician (for upward influence), one constituent group with an equal power level (for lateral influence), and two groups with a lower level of power (for downward influence). The study was carried out in a major medical system in a large, metropolitan city. Using survey data collected from Registered Nurses, Physician Colleagues, Patients and Top-Level Administrators, this research sought to examine the use of influence tactics used by physicians across three strata's of power. All data were collected from the target perspective. The results indicated only two levels of power among the physician constituents. The results also indicate that physicians use a variety of tactics in influencing others and there were several differences found between the groups analyzed. However, the hypotheses were not all supported. There was greater support for the hypotheses, with clearer directional differences when data for the two groups were analyzed. The directional differences of the tactics were not all as expected. Four of the tactics; reason, upward appeal, exchange, and assertiveness, had significant directional differences. Coalitions had suggestive differences between the groups and ingratiation was not used differently among the targets in any significant way. The hypothesized relationships for use of influence tactics against certain influence targets based on the level of power of the target and degree of forcefulness of the tactic was largely upheld when analyzing two groups for level of power.

Keywords

Physician Influence Model; Physician Leadership

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