American Academy of Emergency Medicine

AAEM Contract Guidelines for Emergency Physicians

Preamble: The American Academy of Emergency Medicine sets forth this guideline to advocate for the contractual rights of its members in creating and evaluating employment contracts. This guideline forms the basic components of what the Academy considers to be a fair and equitable arrangement for its members. The guidelines are not comprehensive and do not substitute for professional legal assistance regarding employment contracts. The Academy believes the following principles are essential components of a fair and equitable contract:

  1. The emergency physician should be entitled to full due process as accorded other members of the hospital medical staff. Any restriction or termination of clinical privileges of the emergency physician should be accompanied by the opportunity for a fair hearing through the medical staff. Termination with cause is proper; termination without cause is not. The criteria for termination with cause should be clearly delineated in the contract.

  2. Emergency physicians should not be subject to restrictive covenants, non-compete clauses or other contractual clauses which would prevent them from continuing to practice at or within a certain distance of the site of their employment. This is in the best interest of the community served by the emergency physician.

  3. Emergency physicians should have full access to the books of account. Despite assignment, the individual physician can be held responsible for inaccurate billings and should have the opportunity to review billings made in the physician's name. In order to prevent exploitation and to avoid unwitting involvement in fee-splitting, the emergency physicians should also have the opportunity to review remittances made on their behalf. The above is supported by HCFA policy and statements.

  4. The emergency physician should have the right to participate in full equity profit-sharing after a reasonable trial period not to exceed one year. After the trial period there should also be parity in the schedule regarding nights, weekends and holidays.

  5. In group practice, each member of the group should receive income that is relatively proportionate to the service rendered by the group. Payment for administrative, educational and other essential activities is proper. Differential pay for undesirable shifts such as nights, weekends and holidays is proper, as are pay formulas with a productivity and quality component providing these are agreeable to members of the group.

  6. In group practice, each full time emergency physician should have an equal say in matters affecting the group.

  7. Liability coverage, including payment of the "tail" if appropriate, should be clearly stated in the contract.

  8. The contract with the hospital should not contain clauses referring to participation with hospital-aligned MCOs/HMOs at discounted fee schedules negotiated without approval of the emergency physician group.

  9. Emergency physicians certified by the American Board of Emergency Medicine or the American Osteopathic Board of Emergency Medicine should not be required to obtain various "merit badges" such as ATLS and ACLS.