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Difficult doctor‒patient relationships are a common reality in many health-care organizations. Its harmful impacts have been mainly discussed from the perspectives of patients. However, understanding of its negative effects on physicians is limited. Drawing on the job demands-resources model and the conservation of resources theory, we hypothesize that difficult relationships with patients negatively predict physicians' work engagement, mediated by physicians' personal resources (e.g. prosocial motivation and problem-solving pondering). A sample of 588 physicians from 24 Chinese hospitals completed questionnaires in a two-wave survey. Structural equation modeling and bootstrap estimation results provide support for the hypothesized relationships. Difficult doctor‒patient relationships have a direct and negative effect on physicians' work engagement. Specifically, there is a sequence in which the difficult doctor‒patient relationship first impedes physicians' prosocial motivation, leading to decreased problem-solving pondering, which subsequently impairs physicians' work engagement. Theoretical and practical implications of these findings are discussed.
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