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Transformational leadership has been becoming increasingly vital to the provision of high-quality health care, particularly during major public health emergencies. The present study aims to investigate the impact of transformational leadership on physicians’ performance and explore the cross-level underlying mechanisms with achievement motivations and coping styles among Chinese physicians. During 2017–2019, 1,527 physicians of 101 departments were recruited from six hospitals in China with a cluster random sampling method. Participants completed several questionnaires regarding their job performance, achievement motivations, coping styles, and transformational leadership. Multilevel mediation effects were tested using cross-level path analysis. The result of this study indicated that transformational leadership was applied well in Chinese medical settings with a score of 101.56 ± 6.42. The hierarchical linear model showed that transformational leadership had a cross-level direct positive effect on physicians’ performance (β = 1.524,  p  < 0.05). Furthermore, results of cross-level path analyses revealed that transformational leadership contributed to physicians’ performance by sequentially influencing achievement motivations first and then coping styles. In addition, the path “transformational leadership → positive coping (PC) style → physicians’ performance” showed the strongest cross-level indirect effect. In summary, public health leaders should enhance physicians’ performance by promoting individual development, especially achievement motivation and PC style.

The Impact of Transformational Leadership on Physicians’ Performance in China: A Cross-Level Mediation Model