Commitment shift during organizational upheaval: Physicians' transitions from private practitioner to employee

This longitudinal study examines the individual transition journeys of physicians as their private medical practices are acquired by a large integrated health care system. We test the proposition that transition patterns (trends in an individual's commitments to organization and profession over time) are a function of individual differences in years in profession and perceived organizational enabling characteristics (change involvement, openness to ideas, and work discretion). Three years of survey data were obtained from a panel of 48 physicians who transitioned through an organizational change process. Results challenge traditional assumptions that tenure reinforces commitment and cast doubt on the effectiveness of current medical school curricula in preparing medical graduates to practice in an administrative environment. In addition, results strongly suggest that enabling characteristics of organizational change are critical for compatibility between the organizational and professional attachments of transitioning physicians.