Health care institutions, communication, and physicians' experience of managed care: A multilevel analysis

This study uses the institutional theory of organizational communication (ITOC) to explain physicians' reactions to managed care. ITOC posits that enduring beliefs and practices both transcend and shape particular organizations and organizing. The authors find that physicians' institutional beliefs moderated the negative relationship between managed care medical practice and satisfaction. ITOC also posits that the negotiation of institutional, environmental, organizational, and individual factors occurs through communication. Controlling for these factors, communication with managed care representatives remains significantly and positively related to satisfaction. The results provide support for ITOC and macro approaches to organizational communication research and offer insights for the management of professionals in general and physicians in particular.