Purpose: The purpose of this study is to investigate the theoretical basis for assessing the strategic increase in customer perception of service quality, justice, and relationship benefits. Especially in terms of increasing relationship commitment and customer loyalty in the medical service sector. Research design: Data were collected by questionnaires through specialized hospital services. Survey was conducted on patients who have been treated at a spine specialized hospital. Results: Research shows that service quality, justice, and relationship benefits have the greatest direct impact on relationship commitment, and relationship commitment has a strong direct impact on customer loyalty in the medical service organization. Conclusions: The effect of combination of core and voluntary service behavioral attributes such as service quality, justice and relationship benefits have the most positve impact on relationship commitment and customer loyalty. Administratively, this study contributes to understanding the role of service quality, justice, and relationship benefits in the medical service sector. The results showed that in order to induce service quality, justice and relationship benefits should be facilitated relationship commitment and customer loyalty enlarged.