Do your employment agreements have co-terminus language?
What if the employment agreement doesn't have co-terminus language about termination/privileges? How does the medical staff services department (MSSD) terminate the physician's privileges? If there is no co-terminus language, the formerly employed physician will retain medical staff membership and/or all granted privileges at your organization. If your organization is all right with this arrangement, then there is no problem. They remain at your organization but are no longer a health system-employed physician.
Some organizations have no co-terminus provisions in employment agreements because, quite frankly, they didn’t realize that it was a protection that they should have if things work out poorly. On the other hand, some organizations consciously may not have them in an agreement for legitimate reasons, such as the following:
- The agreement was with a physician who has been in the community for a long time and who has recently been employed. If it doesn’t work out, both physician and health system may be okay with that physician just remaining in the community.
- It may have been part of the negotiation with a newly employed physician. This type of “give” on the part of the health system might be seen with physicians in specialties that have been notoriously difficult to recruit.
- Sometimes things just don’t work out. Some physicians are just not meant to be “employees.” If there is an amicable parting of the ways and the practitioner can continue to bring value to the health system, albeit as an independent physician, then the employer might waive the co-terminus provision as part of the termination negotiation.
The real problem occurs when the termination is not amicable or it is not all right with the health system for the terminated physician to retain medical staff membership/clinical privileges. The absence of co-terminus language in this situation, where the physician desires to maintain membership/privileges, will present a major challenge. Depending on how the physician pursues his or her interest, the health system could face a legal action and/or the physician may choose to exercise due process under the medical staff bylaws.
On the other hand, if there is co-terminus language, the medical staff leader or the MSSD can do nothing about privileges if there is a co-terminus provision in the employment agreement. No employment agreement, no privileges. The problem, as seen above, is when there is no co-terminus provision: The physician will argue that he or she still has privileges and can practice at the hospital. Be prepared for a possible lengthy legal process or medical staff fair hearing process. To avoid all this, it is a best practice to have co-terminus language; conversely, it is a horrendous practice not to have it if it is truly the intention of the health system employer to disallow continued association with the health system after termination. As a medical staff leader, it would be useful to know what the standard practice of your organization is regarding co-terminus language in employed physician agreements.