# **”Crappy Doc” Terminations: An Increasing Issue for Physicians**
## **Introduction**
The process of employment termination within the medical sector is often complex, particularly when it involves accusations of subpar patient care. More frequently, physicians are being let go based on ambiguous assertions of inadequate treatment—what some refer to as “crappy doc” terminations. But what does this term truly signify, and how can physicians shield themselves from wrongful dismissals?
## **The Challenge of “Crappy Doc” Terminations**
Typically, termination due to poor-quality care indicates gross negligence—situations in which doctors commit significant medical mistakes, such as performing surgery on the incorrect patient or being impaired while on the job. However, current trends indicate that terminations can occur for far less clear-cut reasons.
Take the following instances into account:
– A doctor experienced a personal loss and, with a few hours’ notice, informed the hospital about the need for a substitute. The hospital denied this request and warned that being absent would be considered patient abandonment, eventually resulting in termination.
– A female interventional radiologist was let go because her administrator found her floral-patterned lead apron to be unprofessional, without any prior notice or dialogue.
These examples underscore the subjective nature of hospital-imposed terminations—decisions that can lead to catastrophic outcomes for physicians.
## **The Importance of Employment Agreements**
A significant factor contributing to these alarming dismissals is the ambiguous language found in employment contracts. Many agreements empower hospitals to terminate a physician if they “determine” that patient care is at risk. Such broad wording enables hospitals to rationalize nearly any dismissal as a quality-of-care concern.
## **How Physicians Can Safeguard Themselves**
To protect against arbitrary dismissals, physicians should strive for contracts with more precise and protective language. Here are essential actions to consider:
### **1. Seek a Fair Standard for Termination**
Instead of permitting termination based on a unilateral “determination” made by the employer, physicians should negotiate for terms that mandate a **good-faith, reasonable determination**. This ensures that decisions must rely on objective criteria rather than personal biases or capricious judgments.
### **2. Advocate for a Just Quality-Review Process**
Physicians should push for clauses in their contracts that detail a fair, third-party review process before any termination stemming from alleged inadequate care. A suggested approach includes:
– **Hiring an independent reviewer**: The physician and employer should agree on an external, impartial expert within the physician’s specialty to evaluate performance.
– **Chance to rectify**: If any issues arise, the physician should be afforded a reasonable period (e.g., 60 days) to rectify them.
– **Final judgment by an expert**: If the physician remains below acceptable standards, termination may then be warranted.
### **3. Ensure Employer Bears Review Expenses**
Physicians ought to negotiate for the employer to assume all costs associated with any third-party expert evaluation. This ensures that the physician does not incur financial burdens simply to defend their quality of care.
### **4. Steer Clear of the National Practitioner Data Bank (NPDB)**
A termination stemming from a formal hearing often results in a **mandatory report** to the **National Practitioner Data Bank (NPDB)**, which can significantly harm a physician’s career. By selecting an informal dispute resolution method (like third-party expert review), physicians might avoid a reportable incident from being submitted.
## **Distinguishing Peer Review from Employment Termination**
It is crucial to recognize the difference between **contractual employment termination** and **medical staff disciplinary actions**:
– **Employment termination**: A physician may be dismissed by their employer due to claimed poor-quality care.
– **Peer review**: A formal hospital procedure that evaluates whether a physician’s **clinical privileges** should be suspended or revoked.
While employment contracts can offer protections against unjust termination, peer review functions under distinct legal and professional procedures that necessitate additional due process protections.
## **Conclusion**
In light of the persistent physician shortage in the U.S., one might expect healthcare organizations to be diligent in retaining skilled professionals. Regrettably, “crappy doc” terminations indicate that physicians are still susceptible to arbitrary dismissal for subjective or unreasonable grounds.
By thoroughly examining employment contracts, negotiating equitable termination conditions, and assuring third-party oversight in quality-of-care disputes, physicians can more effectively safeguard their careers against unfounded allegations. Given the serious repercussions of wrongful terminations, diligence in contract negotiations is not merely advisable—it is imperative.
—
For more legal insights and strategies to protect physician employment rights, visit **[Physician Agreements Health Law](https://pahealthlaw.com/physicians-attorney/)**.