Physician Employment Agreements: Defining the Scope of Employment

More and more physicians are considering hospital employment as an alternative to private practice.  Whether you are considering becoming a hospital employee or joining a private group practice, however, there are a number of considerations that should be taken into account when structuring your employment agreement.  In the coming days and weeks, I hope to blog about some of these important issues -- the first of which is defining the scope of employment.

As professionals, full-time employed physicians are generally expected to work the hours and provide the services required to ensure the prompt and necessary care of practice or hospital patients. This does not mean however that the employment agreement cannot provide at least the general parameters of the employment commitment including the type of services the physician will be required to render, where he or she will be required to work, the normal work hours and the physician's on-call obligations. For example, if you are being hired to work or concentrate in a specific subspecialty, the employment agreement should state that fact. You do not want to show up for employment as an electrophysiologist and find out that you will be expected to practice general cardiology.

Similarly, if the employer has multiple service sites, unless you’re willing to rotate among those sites or be assigned to sites in your employer’s discretion, consider specifying your primary practice location in the employment agreement so that you cannot be reassigned without your prior consent. Also, the agreement should specify when you will be required to work. If the expectation is that you will work office hours on the weekend, you should know this upfront.

Finally, if you will have on-call responsibilities, you should try to have the agreement specify your maximum on-call obligations or at least that call will be shared equally among the similarly-situated physicians in the practice.
 

Pennsylvania Board of Medicine Proposes Rewrite of Prescribing Regulations

Last week, the Pennsylvania Board of Medicine published proposed regulations amending the physician controlled substances prescribing regulations to, among other things, expand the regs to include butalbital, carisoprodol and tramadol hydrochloride

Under the proposed regulations, these drugs would now be subject to the same requirements applicable in Pennsylvania to physician office prescribing of controlled substances, including that an initial medical history and physical exam be performed before a drug may be prescribed unless emergency circumstances justify otherwise, and that patients receive appropriate counseling regarding the patient’s condition and the drug dispensed.

In addition, among other things, each time a drug is prescribed, administered or dispensed, the medical record must be updated to include the name of the drug, its strength, the quantity and the date it was prescribed, administered or dispensed. For the initial visit when the drug is prescribed, administered or dispensed, the medical record documentation must also include the patient's symptoms, the diagnosis and the instructions given to the patient for the use of the drug. If the same drug is repeatedly prescribed, administered or dispensed, the medical record must also reflect changes in the symptoms, diagnosis and instructions given.

The proposed regulations have been published for public comment. If you're interested in submitting written comments on the regulations you can submit your comments, suggestions or objections to Teresa Lazo, Assistant Counsel, Department of State, P. O. Box 2649, Harrisburg, PA 17105-2649, st-medicine@state.pa.us within 30 days of March 3, 2012. Commenters should reference No. 16A-4933 (Prescribing) when submitting comments.