Objectives To explore the impact of two measures of human resource management reform, namely market-oriented employment status(MOES) and equal pay for equal work(EPEW) with work performance and work-family conflicts among physicians in public hospital in China. Methods We conducted a national cross-sectional survey in 77 public hospitals across seven provinces in China between July 2014 and April 2015, and 2785 physicians involved in this study. Work performance included work engagement, career attrition and patient-centered care. Work-family conflicts were composed of affecting care for family, feeling guilty towards family and receiving complaints from family. RESULTS Participants with MOES only account for 20.25%, those with EPEW only account for 10.36% and those with MOES & EPEW account for 4.35%. After adjusted for potential confounders, compared with those who had no experience of human resource reform measures, participants who had experiences of MOES & EPEW were more likely to report positive work performance (pride in work: aOR = 4.35, 95% CI :2.60–7.28; enjoyment of work: aOR = 4.46, 95% CI :2.71–7.35; turnover intention: aOR = 0.40, 95% CI :0.25–0.65; early retirement: aOR = 0.35, 95% CI: 0.21–0.58; exhaustion: aOR = 0.50, 95% CI :0.31–0.81) and negative work-family conflicts (feeling guilty towards family: aOR = 0.45, 95% CI :0.2810.73; receiving complaints from family: aOR = 0.52, 95% CI :0.32–0.85). Analysis stratified by age ≥35y and <35y showed that the human resource reform measures would have a higher effect on participants age ≥35y compared with those age <35y. CONCLUSIONS The differences stratified by age would reveal that salary system reform may need to be accelerated further and employment system reform may need to be appropriately slowed down, and accordingly, perfecting spiritual incentives measures would be needed to overcome the decline of their effect over time in the future.