McGregor’s Organizational Behavior Theories in Healthcare

Topic: Administration
Words: 1204 Pages: 4


Since the dawn of humanities as a set of disciplines, the world’s leading experts and researching have been attempting to describe the complexity of interpersonal relationship from a theoretical perspective. These relationships comprise a range of interrelated elements that reveal themselves differently across various contexts. In this regard, one of the key areas of knowledge includes theories of organizational behavior. They address the essence of work as one of the most important activities in the life of a person, who is viewed as both an individual and part of an extended team. Such theories refer to the profound concepts of motivation, engagement, and productivity, informing the models of organizational strategic development and human resource management.

The field has seen contributions on behalf of many prominent researchers, including Douglas McGregor who developed theories X and Y. Next, his work was developed by further by William Ouchie as Theory Z. The paradigms of X and Y introduce two opposing views on workers’ motivation depending on the occupational environment, whereas theory Z becomes their natural evolution. The present paper addresses the key postulates of the theories, exploring how they apply in the case of healthcare and nursing, in particular.

Overview of the Theories

The triad of behavioral theories under review originates from the 20th-century pursuit of a framework that would succinctly describe the complexity of professional relationships between leaders and their followers. It refers to the idea of organizational behavior that seeks to eliminate most organizational issues faced by employers, promoting productivity, job satisfaction, and retention on all levels. A major step toward such a theory was made by Douglas McGregor who investigated the nature of motivation behind the worker’s efforts within the company’s framework. The product of his research in formulated in two opposing, yet closely connected theories that describe the two facets of an employer-employee relationship (Prottas & Nummelin, 2018). Following his initial findings, theories X and Y were complemented by Ouchie’s variant Z that introduced a new perspective on the subject matter. The considerable value of this paradigm is recognized across various professional areas, including healthcare and military settings, in addition to the corporate environment (Grigorov, 2020). This way, the ideas behind McGregor’s framework deserve additional exploration.

Theory X

Theory X reflects the first component of McGregor’s initial dichotomy of motivation and productivity. Similar to its Y counterpart, the X variant takes the perception of work as its central concept. More specifically, as per McGregor’s ideas, an average lower-ranking worker tends to value the bottom tiers of Maslow’s pyramid. Because of it, they usually view work as a nuisance and a mere necessity that serves to sustain them. Thus, there is a strong element of coercion in the employer-employee dynamic, as the latter continues to avoid additional responsibility (Daneshfard & Rad, 2020). Per Theory X, workers are not receptive to innovation, preferring security over distant prospects. In other words, they find indeterminacy daunting, since their focus remains on meeting the basic demands rather pursuing self-actualization. Researchers connect the environments in which Theory X prevails to authoritative, “hands-on” management styles. In this case, the resistance of workers and subsequent tensions become a natural response to what is perceived as excessive supervision.

Theory Y

At the same time, McGregor’s Theory Y describes an opposite scenario. In this case, a worker is driven by the upper tiers of Maslow’s pyramid that are associated with creativity and self-actualization. Spoken differently, in Y-environments, people seek to meet their more sophisticated needs. Such endeavors usually incorporate a strong presence of creativity, rapport, and innovativeness. Therefore, Y-workers become more flexible and receptive to change, willing to take new responsibilities to support the development of the organization. This theory refers to the managers who give their followers more freedom, thus creating space for creativity. Conversely, this may lead to a loss of focus, as certain workers may exploit the freedom given (Daneshfard & Rad, 2020). McGregor considered Theory Y to describe the inner motivation of most higher-ranking officers within firms. Their basic are needs are covered by the status and income, thus enabling the pursuit of more sophisticated points. Today, Theory Y resembles the concept of transformative management, in which micro-management is abandoned in favor of value alignment and positive employer-employee relationships are the source of motivation.

Theory Z

Theories X and Y create a dichotomy of management models that describe two possible manners of motivation. In spite of being opposite to each other in nature, these theories are not mutually exclusive. Instead, they simply describe two approaches to organizational behavior that may either be authoritative or liberal with their own downsides and advantages. However, the actual environment rarely exhibits absolute, uniform patterns, making a combination of the two models more likely. Based on this idea, William Ouchie (2018) has formulated the next logical step of the X-Y paradigm, which is Theory Z. In this scenario, a balance between authoritative control and full liberty is sought. The idea is to create a scenario, in which the perspectives of leaders and followers align, creating a strong sense of unity. This way, an individual is guided by a genuine inner desire to support the attainment of goals. Loyalty is the key concept of Theory Z that replaces other instruments of control with a greater efficiency.

Application in Nursing and Healthcare

While being mostly associated with corporate organizations, theories of organizational behavior have transcended these limits. The framework of Theories X, Y, and Z can applied to the sphere of healthcare and nursing, in particular, to address the issue of work motivation and retention in health organizations. Prottas and Nummelin (2018) have investigated the intersection of McGregor’s theories with the reality of the healthcare setting. As per their findings, medical professionals acknowledge the applicability of these models to their work environment. Furthermore, they perceived X and Y as two separate and mutually exclusive approaches, one of which is treated with overt antagonism.

A strong emphasis is laid on the psychological security and stability of the job. Thus, Y-model is seen as the correct avenue of the field’s development as opposed to the X-approach, which is said to prevail in medical organizations (Prottas & Nummelin, 2018). Their perspective is particularly important in the age of COVID-19 that has revealed the lack of retention and excessive stress within the system. For the meaningful progress to occur within the sphere, it is vital to highlight the potential of a mixed approach that would combine liberty with control in a positive unity. This goal can be attained by a mixed X/Y approach, or Theory Z as its logical evolution.


Ultimately, since the 20th century, experts and researchers have sought to describe the nature of organizational behavior. Among the multiple theories that address the complexity of the employer-employee relationship, McGregor’s X/Y dichotomy introduces two opposing perspectives on the subject matter. While X-environments are characterized by authoritative, controlling methods of leadership, their Y-counterparts exhibit liberty and inspiration. However, the reality indicates that a mixed is both more plausible and more efficient. Ouchie’s Z-theory is a natural development of the initial model that introduces a third, balanced perspective. In the context of healthcare, Z-based leadership is essential to overcome the systemic flaws highlighted by the ongoing pandemic, stressing the system.


Daneshfard, K., & Rad, S. S. (2020). Philosophical analysis of theory X and Y. Journal of Management and Accounting Studies, 8(2), 44–48.

Grigorov, G. (2020). Analysis of McGregor, Alderfer and Murray’s motivation theories and their applicability in the military. Science. Business. Society., 5(2), 76–78.

Ouchie, W. G. (2018). Management thinker series. Professional Panorama : An International Journal of Management & Technology, 5(1).

Prottas, D. J., & Nummelin, M. R. (2020). Theory X/Y in the health care setting: Employee perceptions, attitudes, and behaviors. The Health Care Manager, 37(2), 109–117.

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