Customer aggressive behavior and service quality: The role of trust

Healthcare Organizations (HCO) have to cope with aggressive behaviors of customers against employees, a phenomenon which is stressful for employees and harmful for organizations. The current study attempts to discover ways to face up aggressive behavior at the organizational level from twofold, individual and organizational. From that perspective, the key to understanding aggressive behavior is to be found in the service process. Following Bandura's Social Learning Theory (1973), the service setting might encompass elements which are likely to encourage aggressive behaviors. One might claim that organizational elements and personal characteristics could probably lead to aggressiveness against employees which eventually harm also the organization. Furthermore, since service process in HCO often involves risk and uncertainty, trust plays an important role in customer-relationship and has a potential to influence its dynamics. Therefore, customers' trust could serve as a tool that HCOs can utilize to decrease aggressive behavior through attributional process. Yet, despite its potential, customers' trust as a proactive organizational tool for coping with aggressiveness was not studied. The current study explored the relationships between personal and organizational elements, aggressive behavior of customers, and service quality in healthcare setting. Data collection was made through questionnaires for employees (N=394), managers (N=79) and customers (N=575) from 45 primary medicine clinics and organizational archive data concerning formal report and customer's service quality. Our findings show that low level of service quality increased the level of aggressiveness resulting in decreased level of service quality. Also, indicate a different pattern of relationships between organizational and personal elements, aggressiveness against employees, and service quality in clinics with high vs. clinics with low levels of customer trust. From practical aspect, we suggest that trust act as a moderate mechanism that balances customer behavior. Higher levels of customer's trust create more positive attitude toward the organization and its employees, while low level of trust is likely to escalate customers' reaction to organizational elements that might result in aggressive behavior. Organizational investment in nurturing customers' trust will be a strategic decision to coping with the phenomenon and its implications.