PAMED Supports Physicians’ Rights to Independent Clinical Decision-Making

Along with the rapid increase in the number of physicians employed by hospitals or health systems has come the recognition that employed physicians may face challenges unique to that employment. During their May meeting, the PAMED Board approved a package of legislative proposals designed individually and collectively to benefit employed physicians.

While PAMED supports the right of physicians to choose whether to be employed by a hospital or health system, safeguards are needed to protect against inappropriate lay interference in physician clinical decision-making.

Physicians must be free to use their expertise to act in the best interests of their patients. Medical care decisions should not be made by the three A’s – administrators, accountants, and actuaries – whose expertise and focus is on the financial aspects of medical care delivery. Patient access to physicians should also not be impaired when physicians change employment.

To help protect the right of employed physicians employed to retain independent medical judgment and to assure patient access to physicians, PAMED is working on legislative and regulatory initiatives to:

  • Ensure that a physician employed by a hospital/health system retains independent medical judgment in providing care to patients, and that the hospital/health system may not discipline the physician for reasonably advocating for patient care.
  • Ensure that hospitals/health systems appoint a physician leader of their physician practice group who has been approved by the medical staff and that the employed physicians report to this physician leader.
  • Require hospitals/health systems to adopt, maintain, and enforce policies to ensure that an employed physician is free to exercise independent medical judgment in patient care.
  • Require hospitals/health systems to implement a complaint mechanism to process and resolve complaints regarding interference with a physician’s independent medical judgment.
  • Mandate that termination of a physician’s employment with the hospital/health system may not adversely affect clinical privileges at the hospital unless the physician was afforded due process in accordance with the medical staff bylaws.
  • Not allow these mandated protections to be voided or waived by contract.
  • Require Department of Health (DOH) enforcement if a hospital/health system violates the safeguards or retaliates against a physician.
  • Requires the physician group leader to report to the DOH any hospital/health system action or event that compromises the independent medical judgment of an employed physician in caring for a patient.
  • Provide whistleblower protection for physicians whose employment is terminated or subject to retaliation.
  • Prohibit employers from requiring a physician to sign a restrictive covenant that precludes him/her from competing with the employer.
  • Prohibit employers from using loyalty clauses in physician employment contracts to override safeguards or other physician rights or protections.

As legislative and regulatory initiatives on these concerns move forward, watch for more in-depth information, analyses and calls-to-action from PAMED.