Physician-hospital exchanges and extra-role behaviour of physicians: The moderating role of the chief medical officer

The chief medical officer (CMO) plays an increasingly important role in hospitals. The aim of this study is to investigate the impact of the quality of exchange between physician staff and the CMO on the relationship between physicians' perceptions of economic and non-economic physician-hospital exchanges and physicians' organizational citizenship behaviours. A quantitative cross-sectional internet survey study was performed in a sample of 130 self-employed physicians practicing at six Belgian hospitals. Economic exchange was measured by the concepts distributive justice and procedural justice. Non-Economic exchange was measured by the concepts of administrative psychological contract breach and professional psychological contract breach. We focus on two types of organizational citizenship behaviours: physicians' direct personal participation and physicians' indirect stimulating involvement in hospital improvement initiatives. Our results demonstrate a positive relationship between economic exchange and physicians' organizational citizenship behaviours. In contrast, non-economic exchange was not significantly related to extra role behaviours. The positive relationship between distributive justice and both direct personal participation as well as indirect stimulating involvement of physicians was moderated positively by the quality of exchange with the CMO. Similarly, the relationship between procedural justice and direct personal participation was moderated positively. This was not the case for indirect stimulating involvement.