It may be that a physician’s employment contract conditions employment upon becoming a member of medical staff. Covered by such a provision physicians may feel secure that their performance will be evaluated by peers on the medical staff, protecting them from unfair criticism or termination of employment. That feeling of security is absolutely illusory and false.

Medical staff membership does not protect against administrative decisions to terminate a physician because of unfair allegations of poor medical and surgical performance. The only secure relationship with medical staff is one where a physician is a solo practitioner or a member of a group that has no contract with the system or hospital where he practices his specialty.

Otherwise, employment contracts between a physician or his group with a health care system are fraught with employment dangers. The reasons for this situation are several. In some cases, a physician has a personal contract with a health care system. In many cases, a physician has a personal contract with a group and that group has a contract with a health care system.

In the first situation, the system can terminate a physician in spite of a favorable view of the medical staff because the employment contract gives them that power. In the second situation, the system can put pressure on the group to terminate the physician even though the medical staff has not evaluated her practice.

Over the years I have seen many systems and hospitals unfairly terminate physicians without medical staff input or decisions. The worst, of course, is when the medical staff is controlled by the system and the leaders of the medical staff fail to provide due process. Fortunately, that is a rare case.

The most common is the situation where the physician has a personal contract with the system. The physician has a complication or two. The medical staff may or may not conduct peer review. Even if the medical staff conducts a review and it is favorable, the system may terminate the physician pursuant to the employment contract. If the review is unfavorable but proctoring or some remedial study is suggested, short of suspension, the system may still terminate the physician, with or without cause.

A particularly egregious situation exists where the physician has a personal contract with a group and the group has a service contract with the system. I have seen cases where the group is forced by the system to terminate the physician based on the termination provisions of the personal contract with the group. The system brings the group’s service contract into question and the system thereby avoids medical staff review, placing the group in jeopardy of losing its contract.

What is a physician to do if she is caught up in one of these situations? Is it a hopeless situation? Can something be done to protect her rights and employment? The answer is “yes” something can be done. It is not a hopeless situation but does require the skill of a health care employment lawyer.

A health care employment attorney can provide advice and negotiation skills to help a physician navigate the multiple intricacies that each of these situations present. A health care employment attorney can also take your case to mediation or court if your rights are being or have been violated by an aggressive and impersonal health care system.