Performance management of medical specialists: qualitative research into HRM practices and group cultures

The goal of this research is to design an HRM approach for the performance management of medical specialists. This study seeks to understand how different HRM activities impact the performance of medical specialists. In doing so, we also investigated how the professional culture(s) of medical specialists affects the HR activities that impact their performance.
This study employs the AMO framework to explore linkages between the HRM practices and the performance levels of medical specialists (Appelbaum et al., 2002). This framework is based on a performance theory that categorises HRM activities by their effect on the employee’s ability (A), motivation (M), and opportunity (O). Its underlying principle is that the performance level is a function of the employee’s ability, motivation, and opportunity to perform. Each of these three factors can be managed through HR activities. In this study, we assumed that the relationship between the HRM activities and the performance of medical specialists is interactive: depending on the performance outcomes, the HRM instruments should adapt. Based on the analysis of interviews with 35 individuals and of documents published by MST and CWZ, we found various group cultures of medical specialists that have an impact on aspects of their performance, and the unique HRM activities required to manage this performance. The most predominant aspect of these group cultures was found to be the division based on their employment type. There are two main types of employment: medical specialists may be employed directly by a hospital or in a partnership. The impact of the employment relationship is profound, and the interviews suggest a difference in the perception of professional performance, a variation in group culture and atmosphere, and nuances were found in the ability-, motivation-, and opportunity-based HRM activities perceived to be desirable. Additionally, the interviewed HR professionals and managers felt that the employment relationship affects the work approach of the medical specialists, their attitude towards the organisation, acceptance of HR policies, and more. The findings suggest that a nuanced performance management approach for either employment group could be beneficial.