Write clear employment contracts

If organizations merely address legalities in their contracts with physicians and fail to define expectations, they almost guarantee that the physician employment contract is only worth the paper that it is written on. In the contract, the employer must reinforce the behaviors it expects of physicians based on multiple dimensions of physician performance. For example, Health System A has struggled with core measure compliance for myocardial infarction (MI), which is a publicly reported measure of care. To improve performance, the organization may require physicians to provide MI patients recommended care, including beta-blocker medications on admission. The expectation is clearly stated and measurable.

The contract should also specify the physician’s expectations of the employer regarding a host of issues, such as compensation, authority, responsibilities, and whether the organization will manage the physician loosely or tightly. For example, some physicians may require that their employer specify in the contract that clinical judgment and patient care decisions are reserved for the treating physician.

In addition to defining both parties’ expectations, an employment contract should determine how these expectations will be measured and define how the physician and employer will provide each other with feedback.