Hospitals and health care systems are exerting pressure on physician to conform to standards of behavior that often have no relationship to the quality of medical care or to standards that are acceptable to medical staffs.

Most health system employment contracts provide under the “termination for cause terms” that the employer may terminate the employee physician for unacceptable behavior, behavior usually not spelled out in detail and without providing for any due process rights. In other words, the employer can terminate a physician in an arbitrary and capricious manner, simply claiming that behavior was disruptive or unacceptable to management. The medical staff apparatus need not be involved; or if it is involved gives a silent, nodding approval.

What are your rights if a hospital fires you for cause based on some management determined reason, perhaps not even related to behavior, but for some secret management reason? A recent Illinois case, Eakins v Hanna Cylinders, LLC deals with this issue. In summary the case provides that an employer must provide specific performance standards in the employment contract, which the employee must breach in order for the employer to terminate for cause. The standards must be specific and cannot be vague. They would include duties and types of objectionable behavior.

Therefore, when negotiating an employment contract a physician should be certain that the terms related to “for cause” termination are specific. In addition, the physician should be certain that the contract contains language that the employer cannot terminate the physician for cause unless the medical staff agrees that the hospital has met the standards outlined in the physician’s employment contract.