PurposeThis research aims to analyze the factors affecting the people's performance working in the health sector to improve the services the health sector provide to society and increase the efficiency of their institutions.Design/methodology/approachConceptual model covering paternalistic leadership, employee creativity and psychological safety as an intermediary role has been suggested. A questionnaire was applied to 600 employees of three hospitals in Izmir voluntarily and 531 questionnaire data were obtained to test the proposed model. Statistical Package for the Social Sciences-23 and Amos-18 were the statistical software used to analyze the data.FindingsThe results suggest that paternalistic leadership positively affects employee creativity and psychological safety plays a mediating role in this relationship. While the effects of paternalistic leadership on employee resourcefulness are readily available, paternalistic leadership's mechanisms need elucidation.Originality/valuePrevious studies have addressed issues, such as employees' job satisfaction and organizational commitment, covering Far East countries. Yet, the present research's findings enhance the cultural understanding of the conditions, where the paternalistic leader affects employee creativity. Moreover, leader affects must have managerial contributions to institutions.