Differences within the groups of physicians and managers in Dutch hospitals providing leads for intergroup cooperation Running head: Group differences in hospitals

Background: Effective cooperation between physicians and managers is difficult to achieve but is an important factor in successfully implementing improvement initiatives in hospitals. Intergroup literature suggests that large differences between groups hinder effective cooperation. Purposes: Analyze the variation on culture,stereotype,and satisfaction scores, within groups of physicians and managers, to identify subgroups that can be focused on when effective cooperation with the other group is needed. Methodology: We used the GAHP-Questionnaire which assesses the size and content of differences on culture, stereotyping, and satisfaction within and between groups of physicians and managers. The GAHP-questionnaire was sent to all physicians and managers of 46 Dutch general hospitals. Unadjusted and adjusted linear mixed effect models were used to determine significant intragroup differences, related to the demographic characteristics age and gender. For physicians we also analyzed profession, influences of management participation, and type of medical staff organization. For managers we included the hierarchical position. Findings: The response included in the analyses consisted of 888 physicians (24%) and 280 managers (45%) from 37 hospitals. The Cronbach’s alphas were 0.70 to 0.79. Statistical analysis indicated many differences between the subgroups. Managers have a more homogeneous scoring pattern compared to physicians, though executive managers score the smallest gaps with physicians on relative power. For the physicians we see that the subgroups with characteristics female, medical, and physicians who participate in management more than 25% of their time, have the least differences with manager scores. Practice implications: This study shows that diversity within the groups of physicians and managers provides leads to identify members of subgroups, who differ