Abstract

Purpose: This study empirically investigated how physicians' coaching leadership influences word-of-mouth and revisit intentions, with patient satisfaction and brand attachment serving as mediators in Korean primary healthcare institutions. Research design, data and methodology: An online survey was conducted with 306 adults who had utilized primary healthcare institutions within the past three months. To address multicollinearity issues among coaching leadership sub-factors, PLS-SEM analysis was performed using structural multicollinearity modeling and orthogonalization methods. Results: All research hypotheses were supported through systematic competitive model comparison, with Model C (endogenous variable covariance model) demonstrating superior fit indices (SRMR=0.044, NFI=0.923, GoF=0.772). The sequential structure of coaching leadership was confirmed (Direction → Development: β=0.810, p<0.001; Development → Performance: β=0.621, p<0.001; Performance → Relationship: β=0.625, p<0.001), with patient satisfaction (R²=0.758) and brand attachment (R²=0.784) demonstrating strong mediating effects. Word-of-mouth intention (R²=0.795) and revisit intention (R²=0.815) showed high explanatory power. Mediation analysis revealed both complete mediation patterns (VAF=1.000) for individual coaching dimensions and partial mediation effects (VAF=0.371-0.391) for comprehensive pathways. Among participants aged 65 and older, brand attachment exhibited a stronger influence on revisit intention compared to younger groups (β=0.728 vs 0.483, p<0.01). Conclusion: This study empirically demonstrated the mechanism by which physicians' coaching leadership induces positive behavioral intentions through patient satisfaction and attachment. These findings provide practical implications for the development of patient-centered healthcare service policies and for quality improvement in primary healthcare.