Leadership Style and Employee Outcomes in Private Practice Outpatient Physical Therapy Clinics

Background: Workforce retention, employee engagement, and job satisfaction are ongoing challenges in outpatient physical therapy practice. Leadership style has been identified as a potentially modifiable organizational factor that may influence clinician experience and workplace outcomes. Despite extensive leadership research in other health professions, evidence specific to outpatient physical therapy settings remains limited. Purpose: To examine the relationships between private practice outpatient physical therapy clinic directors’ perceived leadership styles and staff physical therapists' work engagement, job satisfaction, turnover intention, leadership effectiveness, satisfaction with leadership, and willingness to exert extra effort. Methods: This cross-sectional correlational study surveyed licensed staff physical therapists employed in private practice outpatient clinics. Participants completed the Multifactor Leadership Questionnaire (MLQ5X), the Utrecht Work Engagement Scale (UWES9), the Job Satisfaction Survey (JSS), and the Turnover Intention Scale. Spearman's rank-order correlations were used to evaluate associations between perceived leadership styles and workforce outcomes. Fifty-one respondents met the inclusion criteria and completed the survey. Results: Transformational leadership demonstrated a significant positive association with employee engagement (ρ = 0.356, P = .010), job satisfaction (ρ = 0.568, P < .001), leadership effectiveness (ρ = 0.753, P < .001), satisfaction with leader (ρ = 0.782, P < .001), and extra effort (ρ = 0.662, P < .001). Transactional leadership was positively associated with job satisfaction, leadership effectiveness, satisfaction with the leader, and extra effort (all ≤ .002). Laissez-faire leadership demonstrated significant negative associations with job satisfaction (ρ = ­0.380, P = .006), leadership effectiveness (ρ = ­0.516, P < .001), satisfaction with the leader (ρ = -0.509, P < .001), and extra effort (ρ = ­0.383, P = .006). No significant relationships were observed between overall leadership style and turnover intention. Conclusion: Leadership style was strongly associated with multiple workforce outcomes among outpatient physical therapists. Transformational leadership demonstrated the most favorable relationships with engagement, satisfaction, and perceived leadership effectiveness, whereas laissez-faire leadership was associated with poorer workplace outcomes. Leadership development may be a practical strategy to improve clinician satisfaction, workforce stability, and organizational performance in private practice outpatient physical therapy settings.