Aims: Prior research has reported high levels of stress for physicians, but determinants of this stress are poorly understood. We explored whether problems in decision-making procedures and treatment of employees, as expressed in the theory of organizational fairness, may contribute to psychological distress in hospital physicians. Methods: Structural equation modelling (LISREL) was based on survey responses from 251 male and 196 female physicians working in 11 public hospitals in Finland. Results: Low organizational fairness increased the risk of psychological distress in male physicians but not in female physicians. In the former group, the association between organizational fairness and psychological distress was partially mediated by decreased job control and increased workload. Conclusions: These findings suggest that broadening the view from the traditional psychosocial work characteristics to justice in management may assist in efforts to promote physicians' health and well-being.
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