The Reward of Virtue: Examining Roles of Patient Gratitude, Physician Affect, and Physician Rumination in Linking Patient-Centered Communication and Physician Turnover.

Increasing physician turnover poses challenges to healthcare institutions worldwide. Patient-centered communication (PCC), which increases patient-physician communication quality and physician work experiences, is considered a potential solution. Nonetheless, little is known about its actual effects and underlying mechanisms on healthcare providers themselves. Drawing on an integrated framework based on affective event theory and affect theory of social exchange, this study proposes and tests a pathway model linking PCC and physician turnover intention. Analyzing survey data collected from Chinese physicians (N = 600) with the structural equation model technique, the findings show that PCC is negatively associated with turnover intention. Particularly, this association is sequentially mediated by 1) receipt of patient gratitude, positive affect after consultations and positive work rumination (β = -.002, 95%CI[-.006, -.0002]), 2) receipt of patient gratitude, positive affect after consultations and negative work rumination (β = -.003, 95%CI[-.007, -.0004]), 3) receipt of patient gratitude, negative affect after consultations and positive work rumination (β = -.003, 95%CI[-.007, -.0004]), and 4) receipt of patient gratitude, negative affect after consultations and negative work rumination (β = -.002, 95%CI[-.006, -.0002]). On this basis, this study contributes to the literature by elucidating how PCC benefits physicians through their active elicitation of positive affective events.