Hospital employment: Are policies needed to protect physicians?

While the appeal of not having to run a business continues to attract more physicians, various groups urge policymakers to help ensure that hospital contracts don't put employed doctors or their patients at an unfair disadvantage.

For example, the American Academy of Family Physicians (AAFP) has recently recommended rules that protect employed physicians' rights to due process before being fired or having their privileges revoked from a hospital.

Reid Blackwelder, M.D, AAFP board chair, urged in a May 4 letter to Andy Slavitt, acting administrator for the Centers for Medicare & Medicaid Services, that the agency forbid hospitals and physician staffing companies from including a clause in employment contracts allowing hospital administrators to terminate a physician with or without cause, unless the termination receives a fair hearing.

"CMS should promote policies that require physicians are provided fair hearings and appellate reviews…and that these rights cannot be denied through a third party contract," he wrote.

Meanwhile in Tennessee, Michel McDonald, M.D., the new chair of the state medical society spoke with the Nashville Business Journal about other challenges to employment. "It means that as a physician you might not be as involved in contracting with insurance companies, because your employer takes care of that," she said. "Even sometimes hiring and firing of employees or a lot of the logistical business issues that [would be different] if you were the actual business owner." The medical society has made it a priority to make sure employed physicians retain a voice in such decisions, according to the publication.

The most recent data by consulting company Accenture show that the number of independent physicians will decline to 33 percent in 2016, noted a recent article from the Orlando Sentinel. Concern that this trend adds cost for patients has led to the creation of a national trade group, Association of Independent Doctors (AID), which has 300 members in nine states.

"What the private doctors want is for everyone to play on a level playing field. In other words, whoever does the best work, whoever has the best outcome, whoever has the best patient satisfaction, those people we feel should do the majority of the work," AID member Andrew Taussig, M.D., a cardiologist at Central Florida Cardiology Group, told the Sentinel.

To learn more:
- read the letter (.pdf)
- here's the post from the Nashville Business Journal
- check out the article from the Orlando Sentinel