Corporate Practice

AAEM sent the following letter to 6,594 hospital administrators in the United States. As you will read in the letter, AAEM President, Robert McNamara, MD FAAEM, addresses main issues relating to staffing arrangements for Emergency Departments. AAEM has serious concerns in relation to fee-splitting and corporate practice of medicine issues. Once again, AAEM stands firm in our belief that hospitals are best served by contracting with emergency physicians who are equal partners in a group practice.

Dear Hospital Administrator:

As a hospital administrator you are no doubt aware of the existence of a wide variety of physician staffing arrangements for Emergency Departments. The American Academy of Emergency Medicine would like to bring to your attention serious concerns that may exist regarding contract arrangements involving emergency physician STAFFING COMPANIES. The main concerns are as follows:

1. Fee-Splitting

In addition to the code of ethics of various medical associations, fee-splitting is barred by most states and the federal government (42 USC 1320a-7b(b)). Contractual arrangements that force emergency physicians to divide their professional fees are subject to scrutiny under these statutes. In certain contractual arrangements emergency physicians are forced to give up a portion of their fee beyond fair market value for the services they receive.

2. Corporate Practice of Medicine Issues

The vast majority of states have prohibitions on the corporate practice of medicine that prohibit unlicensed businesses and individuals from sharing in professional income. Many Emergency Department staffing companies direct physician income to lay persons, a few are even publicly traded companies directing physician fees to stockholders.

The American Academy of Emergency Medicine has informed its members of these matters and we will support their efforts to practice in environments free of such concerns. It is our belief that hospitals will benefit from examining their Emergency Departmental contractual arrangements in light of the above. It is our opinion that hospitals are best served by contracting with emergency physicians who are equal partners in a group practice. In such an arrangement, each emergency physician is invested in the success of the Emergency Department thereby benefiting the hospital.

More detailed information on concerns regarding the corporate practice of Emergency Medicine and fee-splitting can be found at our website at www.aaem.org or at www.911emergency.org.

Feel free to contact the Academy regarding these matters.

Sincerely,

Robert M. McNamara, MD, FAAEM
President