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The American Medical Association during its semi-annual policy meeting has adopted guidelines for physicians entering into contractual employment arrangements.

With physicians increasingly becoming hospital employees, almost a third of final year residents now list hospital employment as their first choice of practice setting, according to the association. The employment guidelines cover such areas as conflicts of interest, advocacy, contracting, hospital-medical staff relations, performance evaluations, and compensation.

Under the conflicts of interest guidelines, for instance, employed physicians should be free to vote, speak and advocate on any matter regarding patient care interests, the profession, health care in the community and independent exercise of medical judgment, according to the association. “Employed physicians should not be deemed in breach of their employment agreements, nor be retaliated against by their employers, for asserting these interests.”

A contracting provision spells out the rights that AMA believes patients and physicians have when a physician leaves an organization, including rights to medical records:

“When a physician’s employment status is unilaterally terminated by an employer, the physician and his or her employer should notify the physician’s patients that the physician will no longer be working with the employer and should provide them with the physician’s new contact information. Patients should be given the choice to continue to be seen by the physician in his or her new practice setting or to be treated by another physician still working with the employer.

“Records for the physician’s patients should be retained for as long as they are necessary for the care of the patients or for addressing legal issues faced by the physician; records should not be destroyed without notice to the former employee. Where physician possession of all medical records of his or her patients is not already required by state law, the employment agreement should specify that the physician is entitled to copies of patient charts and records upon a specific request in writing from any patient, or when such records are necessary for the physician’s defense in malpractice actions, administrative investigations, or other proceedings against the physician.”

The employment and contractual guidelines are available here.