The American Academy of Emergency Medicine strongly supports fair working practices for emergency physicians. Consequently, it will certify excellence in the ED workplace if ED physician employees are guaranteed five workplace conditions.

Please confirm that these workplace conditions are present within your organization.

1. A reasonable due process policy.
   View examples of fair employment practices.
   Unilateral termination without cause and without rights defined in the medical staff bylaws is acceptable only during a provisional period of employment, not to exceed one year. Termination with cause requires a fair hearing upon request of the terminated physician.
2. A reasonable policy of financial transparency that protects physicians against financial exploitation.
   View examples of fair employment practices.
   Partners are automatically provided information on total group charges, collections, management, and operational expenses, and other group income distribution on at least a quarterly basis.
3. A reasonable policy of financial equity that allows physicians to share in the department's profits.
   View examples of fair employment practices.
   For democratic groups, full partnership opportunities are available through a predefined process that does not exceed three years. Share distribution among partners is transparent.
4. A reasonable policy of political equity that allows physicians to improve their own working conditions.
   View examples of fair employment practices.
   Governance procedures are published, with processes for election of leadership and partners, appointment of medical directors and administrators, and bylaws amendments.
   
   Practicing physicians must make all practice decisions (including those involving hiring, firing, staffing levels, and clinical processes) and have a primary fiduciary responsibility to their patients, not to a corporate entity or shareholders. No layperson (defined as a non-physician or non-practicing physician) can have a commercial interest in the practice or the right to control the professional judgment of any practicing physician. No layperson may be a corporate officer or director or occupy a position of similar control. Physician employment by hospitals or non-profit entities is permissible when in accordance with state law.
5. Employment arrangements that do not impose post-contractual restrictions.
   View examples of fair employment practices.
   Non-compete or similar clauses that affect where a physician may work upon leaving the group or upon group turnover are not conditions of employment.

The Academy recognizes the existence of many different emergency department business models. The above examples are provided as guidelines that comply with the listed principles. These guidelines are not absolute, but reflect the spirit of fairness encouraged by the Academy. Thus, any group that believes it meets conditions for fairness is encouraged to submit an application for a certificate of excellence. Applications will be reviewed by the Academy. Departments that are deemed to fall outside fairness criteria will be provided direct feedback and given ample opportunity to reapply.