Understanding the Hidden Dangers in Physician Employment Agreements
Protecting Your Career: Physicians often assume that their job security is safeguarded by their employment agreements. However, vague contract language can leave them vulnerable to sudden and unjust terminations. Many doctors have lost their positions due to subjective and ambiguous accusations of “poor-quality care”—even in situations where their actions were reasonable and well within professional standards.
The Risks of Poorly Defined “Quality of Care” Standards
Protecting Your Career: Take, for instance, the case of a rural hospital physician who had to call in just hours before a scheduled shift due to a family emergency. Instead of empathy or accommodation, the hospital determined that this constituted patient abandonment—leading to termination. Another physician, an interventional radiologist, was dismissed because she wore a purple floral lead apron deemed “unprofessional.”
These cases highlight how loosely defined terms in employment contracts allow hospital administrators to justify terminations based on personal opinions rather than objective standards. Physicians must be aware that some contracts allow an employer to terminate employment if they “determine” that patient care is jeopardized—without requiring any external review or justification.
Strengthening Your Contract: Key Provisions to Look For
Physicians can take proactive steps to safeguard themselves from unfair dismissals. When reviewing an employment agreement, consider the following:
1. Demand a “Good-Faith, Reasonable Determination” Clause
Instead of vague language that allows termination based on a subjective determination, ensure that any quality-of-care concerns must be assessed in “good faith” and be “reasonable.” While this does not prevent frivolous terminations, it does provide a basis for disputing unfair actions.
2. Require an Independent Third-Party Review
A contract should specify a structured process for evaluating a physician’s performance. One effective solution is appointing a mutually agreed-upon physician with expertise in the same specialty to objectively determine if the physician meets the standard of care.
If any deficiencies are noted, the physician should be granted a reasonable period—such as 60 days—to address them. Only if the independent expert determines that standards are still not met should termination proceed. Additionally, ensure that the employer covers all costs associated with this process.
3. Avoid an NPDB Report
Terminations involving alleged “poor-quality care” can trigger mandatory reporting to the National Practitioner Data Bank (NPDB), which can have severe long-term consequences on a physician’s career. The independent review process provides an alternative pathway that avoids an NPDB report, preserving future employment opportunities.
Protect Yourself Before Signing
With the ongoing physician shortage, one might assume that doctors are protected from arbitrary terminations. Unfortunately, vague contract language continues to put physicians at risk. The best defense is a well-negotiated contract that includes clear, fair, and enforceable termination provisions.
At Stanford Physician Advocate, we equip physicians with the knowledge and resources they need to navigate employment agreements and advocate for their rights. Before signing any contract, consult a legal expert to ensure your interests are fully protected.
For more insights on physician advocacy and contract negotiation, visit StanfordPhysicianAdvocate.org.