Emergency medicine's unique nature makes noncompete agreements particularly ill-suited to the specialty.
Emergency physicians are clearly negatively affected—personally and professionally—by noncompete clauses, as revealed in a new questionnaire by members of the American College of Emergency Physicians (ACEP).
As such, ACEP is urging the Federal Trade Commission (FTC) to finalize its proposed rule to ban noncompete clauses in employment contracts. Doctors and other healthcare workers who work under noncompete clauses would be freed of those hiring restrictions under the FTC’s proposed rule.
“ACEP carefully monitors the emergency medicine labor market in pursuit of our overall goal to support emergency physicians and ensure that they are treated fairly by their employer and practice in an environment where they can best care for their patients,” Christopher S. Kang, MD, FACEP ACEP, president of ACEP, said in a letter to Lina M. Khan, FTC chair.
“Therefore, ACEP supports the commission’s proposal to categorially ban noncompete clauses and we urge it to finalize the regulation as proposed to help address the current anticompetitive conditions faced by many emergency physicians that limit their right to freely practice medicine in their communities,” he wrote.
Indeed, emergency medicine’s unique nature makes noncompete agreements particularly ill-suited to the specialty; emergency physicians do not have a “book of business” of existing patients with whom they have established and ongoing relationships. If they leave for another group or hospital, no patients will follow them to their new practice, so their departure does not lose their previous employer any business, Kang explained.
Some 90% of the 75 emergency physician respondents to the ACEP survey said noncompete clauses make it harder for emergency physicians to switch employers, and more than half—59%—said they would seek a different job locally if they were not subject to the clause.
“This has without a doubt caused an impact on fair market value of our compensation as we have not received a raise in over five years and because leaving the company would cause all of the emergency physicians a hardship of moving, we all accept the bad conditions under which we are working,” one emergency doctor said.
Another worried about patient care: “I feel trapped, and worry every shift that this noncompete limits my ability to advocate for my patients—since a core part of the job of a good emergency doctor is advocating for patients even when it causes work for more ‘powerful’ specialists within the hospital,” the physician wrote.
Noncompetes can particularly affect rural and underserved areas that are struggling to keep doctors.
“As I am working in an area of the country that is in dire need of emergency physicians, if I leave my current job, I would be depriving this high-need area of a physician, as I would be forced to find work outside this area,” a rural physician responded. “Moreover, this area would be losing someone who has been actively putting down roots and becoming a member of the community, with a knowledge base of the local resources and culture.”
Other emergency physicians revealed how noncompete clauses—being “chained to a single employer,” as one put it—had affected their personal and family life.
“My noncompete is geographically quite broad, and basically means that if I leave my current employer, I will have to move my special-needs kids out of the school system we moved here for,” one physician responded.
Said another: “I recently moved away from my hometown and my wife’s family due to a noncompete clause. This was a very trying time for my family and my children. I had to tear them away from their school, friends, and sports. After the move my children experienced bullying at school, lack of sports options, and one child developed severe anxiety requiring treatment. I then lost significant income and equity selling my house.”
Noncompete clauses also prohibit emergency physicians from “moonlighting” at other health facilities, an opportunity that can allow physicians to expand their skills, enhance job flexibility, and help them earn additional income. Of respondents who have had a noncompete clause in their contract in the past five years, 12% felt limited by their inability to moonlight.
“As a fellow in my late 30s and the only physician in my family, I have been the one to provide when my family needs money,” one ACEP member responded to the survey. “Not being able to leverage a contract or even moonlight at a nearby facility over a holiday weekend forces me into continued financial strain. No one should get to say what I do or where I work in my free, unscheduled time.”
Giving more control
“Restricting an emergency physician’s ability to choose a job can stall or upend their career, contribute to workplace dissatisfaction, and accelerate currently high rates of burnout, especially in rural or underserved communities where it is already challenging to attract and retain physicians,” Kang wrote.
“Finalizing this ban would be a fundamental step that can empower emergency physicians,” he wrote, “to take more control over their careers.”
“Restricting an emergency physician’s ability to choose a job can stall or upend their career, contribute to workplace dissatisfaction, and accelerate currently high rates of burnout, especially in rural or underserved communities where it is already challenging to attract and retain physicians.”
— Christopher S. Kang, MD, FACEP ACEP, president, American College of Emergency Physicians
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
Under the FTS’s proposed rule, doctors and other healthcare workers who work under noncompete clauses would be freed of those hiring restrictions.
90% of ACEP survey respondents said noncompete clauses make it harder for emergency physicians to switch employers.
12% of respondents who have had a noncompete clause in their contract in the past five years feel limited by their inability to moonlight.