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Hospital-physician exchanges : the moderating effects of the Chief Medical Officer and organizational trust

Jeroen Trybou (UGent) , Paul Gemmel (UGent) and Lieven Annemans (UGent)
Author
Organization
Abstract
Background: Hospital-physician relationships (HPRs) are critical to hospitals’ organizational success. A distinction can be drawn between economic and noneconomic exchange. Physician leadership and organizational trust are important components of managerial strategies aiming at optimizing HPRs. Purpose: The purpose of this study was to investigate the moderating role of the quality of Leader-Member eXchange with the Chief Medical Officer (LMX CMO) and organizational trust in the relationship between economic and noneconomic exchange and physicians’ organizational attitudes and Organizational Citizenship Behavior (OCB). Methodology: Self-employed physicians of six Belgian hospitals were surveyed. The moderating role of LMX CMO and organizational trust in the relationships of (distributive and procedural) organizational justice and (administrative and professional) psychological contract breach and physicians’ key organizational attitudes and OCB were assessed. Findings: Our results showed a relationship between both psychological contract breach and organizational justice and physicians’ organizational attitudes. In contrast to organizational justice, no relationship was found between psychological contract breach and OCB. Quality of exchange with the CMO and organizational trust buffered the negative effect of psychological contract breach and reinforces the positive effects of organizational justice with respect to physicians’ organizational attitudes. When OCB is considered, only a relationship with organizational justice was present which was moderated by the quality of exchange with the CMO. Remarkably, physicians who experience low levels of LMX were less affected by perceptions of justice, whereas the work behaviors decreased as justice decreased among physicians that experience high levels of LMX. Conclusion: Our results demonstrate that physician leadership and organizational trust are important to physician-hospital exchanges. Both economic and noneconomic aspects are important when considering physicians’ key organizational attitudes. However, with respect to organizational citizenship only the economic dimension of exchange was found to be significant. The reciprocity dynamic can be enhanced by high-quality exchange with the CMO and by building organizational trust.
Keywords
Organizational Justice, Psychological Contract, Leader-Member Exchange, Hospital-Physician Relationships, Trust

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MLA
Trybou, Jeroen, Paul Gemmel, and Lieven Annemans. “Hospital-physician Exchanges : the Moderating Effects of the Chief Medical Officer and Organizational Trust.” Organisational Behaviour in Healthcare, 9th International Conference, Papers. Copenhagen, Denmark: Copenhagen Business School, 2014. Print.
APA
Trybou, J., Gemmel, P., & Annemans, L. (2014). Hospital-physician exchanges : the moderating effects of the Chief Medical Officer and organizational trust. Organisational Behaviour in Healthcare, 9th International conference, Papers. Presented at the 9th International Organisational Behaviour in Healthcare conference: When health policy meets every day practices, Copenhagen, Denmark: Copenhagen Business School.
Chicago author-date
Trybou, Jeroen, Paul Gemmel, and Lieven Annemans. 2014. “Hospital-physician Exchanges : the Moderating Effects of the Chief Medical Officer and Organizational Trust.” In Organisational Behaviour in Healthcare, 9th International Conference, Papers. Copenhagen, Denmark: Copenhagen Business School.
Chicago author-date (all authors)
Trybou, Jeroen, Paul Gemmel, and Lieven Annemans. 2014. “Hospital-physician Exchanges : the Moderating Effects of the Chief Medical Officer and Organizational Trust.” In Organisational Behaviour in Healthcare, 9th International Conference, Papers. Copenhagen, Denmark: Copenhagen Business School.
Vancouver
1.
Trybou J, Gemmel P, Annemans L. Hospital-physician exchanges : the moderating effects of the Chief Medical Officer and organizational trust. Organisational Behaviour in Healthcare, 9th International conference, Papers. Copenhagen, Denmark: Copenhagen Business School; 2014.
IEEE
[1]
J. Trybou, P. Gemmel, and L. Annemans, “Hospital-physician exchanges : the moderating effects of the Chief Medical Officer and organizational trust,” in Organisational Behaviour in Healthcare, 9th International conference, Papers, Copenhagen, Denmark, 2014.
@inproceedings{4365559,
  abstract     = {Background: Hospital-physician relationships (HPRs) are critical to hospitals’ organizational success. A distinction can be drawn between economic and noneconomic exchange. Physician leadership and organizational trust are important components of managerial strategies aiming at optimizing HPRs.
Purpose: The purpose of this study was to investigate the moderating role of the quality of Leader-Member eXchange with the Chief Medical Officer (LMX CMO) and organizational trust in the relationship between economic and noneconomic exchange and physicians’ organizational attitudes and Organizational Citizenship Behavior (OCB).
Methodology: Self-employed physicians of six Belgian hospitals were surveyed. The moderating role of LMX CMO and organizational trust in the relationships of (distributive and procedural) organizational justice and (administrative and professional) psychological contract breach and physicians’ key organizational attitudes and OCB were assessed.
Findings: Our results showed a relationship between both psychological contract breach and organizational justice and physicians’ organizational attitudes. In contrast to organizational justice, no relationship was found between psychological contract breach and OCB. Quality of exchange with the CMO and organizational trust buffered the negative effect of psychological contract breach and reinforces the positive effects of organizational justice with respect to physicians’ organizational attitudes. When OCB is considered, only a relationship with organizational justice was present which was moderated by the quality of exchange with the CMO. Remarkably, physicians who experience low levels of LMX were less affected by perceptions of justice, whereas the work behaviors decreased as justice decreased among physicians that experience high levels of LMX.
Conclusion: Our results demonstrate that physician leadership and organizational trust are important to physician-hospital exchanges. Both economic and noneconomic aspects are important when considering physicians’ key organizational attitudes. However, with respect to organizational citizenship only the economic dimension of exchange was found to be significant. The reciprocity dynamic can be enhanced by high-quality exchange with the CMO and by building organizational trust.},
  author       = {Trybou, Jeroen and Gemmel, Paul and Annemans, Lieven},
  booktitle    = {Organisational Behaviour in Healthcare, 9th International conference, Papers},
  keywords     = {Organizational Justice,Psychological Contract,Leader-Member Exchange,Hospital-Physician Relationships,Trust},
  language     = {eng},
  location     = {Copenhagen, Denmark},
  pages        = {39},
  publisher    = {Copenhagen Business School},
  title        = {Hospital-physician exchanges : the moderating effects of the Chief Medical Officer and organizational trust},
  year         = {2014},
}