The Hospital as a Social Organization: A Conceptual Review of Patient–Provider Conflict and Healthcare Quality in Nigeria

Abstract

Patient–provider conflict is an important but insufficiently theorized dimension of healthcare delivery in Nigeria. Existing studies have examined related concerns, including patient dissatisfaction, communication failures, treatment disagreement, mistrust, disrespectful care and violence against healthcare workers. These strands of evidence are often treated as separate problems, making it difficult to understand how conflict develops within the wider social and organizational environment of hospitals. This conceptual review addresses that gap by examining patient–provider conflict as a relational and social-organizational process rather than simply as an outcome of individual misconduct or patient dissatisfaction. Drawing on social conflict theory and recent empirical evidence from Nigeria, the paper conceptualizes conflict as emerging when patients’ expectations, interests, preferences and perceived rights come into tension with providers’ professional judgments, institutional responsibilities, communication practices and organizational constraints. The proposed framework links structural and institutional conditions to interactional processes involving communication, expectations, trust, power, participation and perceived fairness. These processes shape whether disagreement remains manageable, develops into interpersonal conflict or escalates into aggression and relationship breakdown. The review further proposes that conflict has implications for communication, satisfaction, trust, adherence, continuity, patient safety and broader dimensions of healthcare quality. The paper distinguishes its contribution from the recent structural equation model proposed by Unaam et al. (2026) by offering a sociological explanation of the mechanisms and trajectories through which organizational conditions become relational conflict. Seven conceptual propositions are advanced to guide future empirical research in Nigerian healthcare settings.