Guide for Problems Docs Face as Employees

Physicians have a lot of challenges to face in their jobs going forward between potential Medicare spending cuts, the detestable sustainable growth rate, rampant burnout and too many patients. To help, the American Medical Association (AMA) recently released its new principles for physician employment.

The AMA’s principles are for physicians entering into employment and contractual agreements. The guideline “address the unique challenges to professionalism and the practice of medicine arising from the physician employment trend,” according to the AMA.

In particular there are six potentially problematic aspects of the employer-employee relationship that are addressed by the AMA: conflicts of interest, advocacy, contracting, hospital-medical staff relations, peer review and performance evaluations, and payment agreement.

“The Principles for Physician Employment provide a broad framework to help guide physicians and their employers as they collaborate to provide safe, high-quality, and cost-effective patient care,” AMA Board Member Joseph P. Annis, MD, said. “The guidelines reinforce that patients’ welfare must take priority in any situation where the interests of physicians and employers conflict.”

Considering more and more physicians are becoming employees instead of employers, the guidelines can help those making the jump from an independent practice to hospital employment.

“Nobody wants to be Marcus Welby anymore, practicing alone or with a partner, and fewer hospitals are seeking solo doctors for their communities,” James Merritt, founder of Merritt Hawkins, said in a statement in July.

A survey by Merritt Hawkins in July revealed that the number of recruiting assignments for solo practitioners is almost non-existent at just 1% — a huge drop from 22% in 2004. Meanwhile hospital-employed physicians increased to 63% from 11%. The company is forecasting that 75% of newly hired physicians will be hospital employees by 2014.

As more and more physicians are now employees rather than business owners, the AMA wants to be entirely sure that physicians are equipped to deal with any potential conflicts of interest.

“The AMA is well positioned to help employed physicians address professional conflicts that may occur in the employer-employee relationship,” Annis said. “The Principles for Physician Employment add to the AMA’s growing range of products and services that help physicians understand and manage their employment and contractual relationships.”

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AMA Principles for Physician Employment