Purpose - This study is to clarify the structural relationship between the direct supervisor and organizational commitment and organizational citizenship behavior through mediation of the Leader-member exchange (LMX) in the hospital organization, and to confirm the mediating effect of the LMX. Through this study, we will provide basic data on the aspects of HR to enhance organizational immersion and organizational civic behavior in hospital organizations, and present suggestions on academic contribution and effective organizational operation measures. Research design, data, and methodology - This study is to investigate the relationship between authentic leadership and OC and OCB of the organization member, which is proposed to secure more active and high competitiveness in the recent changing medical environment, with multi-regression and B&K(1986) method. For this purpose, 653 employees of senior hospitals in Seoul and Kyeong-In area were surveyed using structured questionnaires. Each questionnaire was composed of 7-point scale, and each hypothesis was testified by multiple leaner regression and by BK method for testifying mediator effect. Result - As a result of the analysis, it was found that the male and non-medical staff had higher recognition level than the medical staff in the LMX, organizational commitment and organizational citizenship behavior. In the senior management or more than 5 years’ experience group, organizational commitment and organizational citizenship behavior were recognized higher than the group of subordinate managers. Second, authentic leadership has a positive influence on LMX, organizational commitment and organizational citizenship behavior, and LMX has a significant positive impact on organizational commitment and organizational citizenship behavior. In addition, as a result of analyzing LMX mediating effect in the relationship of authentic leadership and organizational effectiveness by BK method, LMX had partial mediating effects between authentic leadership and organizational citizenship behavior, and between authentic leadership and organizational commitment. Conclusion - Results of the study confirmed that all the members of the hospital organization that were lacking served as positive factors for the relationships of authentic leadership and LMX, and authentic leadership and organizational effectiveness. It is expected that the hospital organization will be able to suggest such as the organizational approach to expect high organizational effectiveness centering on authentic leadership ability as psychological capital.