Physicians should watch out for confidentiality clauses in employment contracts

By Aine Cryts

Physicians need to pay close attention to confidentiality clauses that often appear in employment contracts and which may not be in their best interests, according to the authors of a commentary recently published in the Annals of Internal Medicine

Some confidential clauses hold a significant threat for physicians, write Roy M. Poses, M.D., clinical professor of medicine at Alpert Medical School and Brown University in Providence, Rhode Island, and Wally R. Smith, M.D., professor of internal medicine at Virginia Medical Center in Richmond.

Some of the contract language that physicians should be alert to, according to the authors, includes: leakage control clauses that encourage employed physicians to refer patients within their healthcare system--whether or not it's best for the patient; termination without cause clauses; and gag clauses that don't allow physicians to discuss concerns about problems, such as their employer's electronic health record (EHR) even if there are quality or patient safety implications.

"We urge medical societies to better inform physicians about the challenges of being employed, including risky contract clauses, and help support physicians who struggle with them," write Poses and Smith in the commentary. "Unfortunately, without broader reforms of the system, physicians may conclude that they must organize to collectively bargain with intransigent employers."

The authors' critique of confidentiality clauses--which they distinguish from safeguards that protect patient confidentiality--is that they are so broad in scope that they often include all materials created by the hospital system. And that's problematic because such clauses could "bury evidence of poor quality or safety," they write.

Termination without cause clauses--because they can allow health systems to fire physicians for raising quality or ethical issues--are also problematic, write Poses and Smith.

To learn more:
- read the commentary

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