I confirm/certify that all of the following are true:
- With the provisional period not to exceed one year, our physician group provides our emergency physicians access to predefined due process.
- Our physician group, or its controlling entity, has a predefined mechanism that regularly and automatically provides all our emergency physicians the detail of their own professional charges and collections. This information shall be automatically provided to the physician on a quarterly basis.
- Our physician group provides our emergency physicians: a) a predefined and reasonable pathway to full partnership that does not exceed three years, b) the review process and criteria used to grant full partnership, c) a predefined entry and exit policy, and d) the exact distribution of all shares held in the group. For the purpose of this certificate, a full partner is defined as an equal shareholder with equal voting status.
- Our physician group, or its controlling entity, has a predefined mechanism that regularly and automatically provides all full partners: a) the total charges and collections for the group, and b) the distribution of all group income including all management and operational expenses including coding/billing/collecting, professional liability insurance, non-physician employee salaries, and physician administrative stipends. This information shall be automatically provided to the partners on a quarterly basis.
- Our physician group provides our emergency physicians with the details of our governance process including the method of electing leaders and new partners, appointing medical directors and administrators and revising the bylaws.
- Our physician group does not impose post contractual restrictive covenants (i.e., non-compete clauses).
- Physicians, or physician-extenders working under the direct supervision of physicians, make all clinical decisions in our practice. Our physicians have a primary fiduciary responsibility to their patients, not to a corporate entity or shareholders.
- In order to ensure compliance by the group, all full partners in the group eligible for AAEM membership will maintain such membership. As AAEM members, they will be subject to its bylaws including the code of ethics, and any available sanctions therein.
Physician groups in compliance with this AAEM certification statement may advertise their compliance and use it in their promotional materials. Such groups will automatically qualify for the AAEM job bank or display booths at AAEM conferences.
All AAEM members are entitled to request and obtain a certified copy of this original certificate from AAEM. The failure of an emergency physician group to comply with their certificate may result in charges and sanctions.
Any changes in business practices that negate the above attestation will result in prompt notification to AAEM
Subscribed and sworn to before me on the day, month and year set forth.
Signature Notary Public
My Commission Expires:_______________________