Noncompete clauses affect between 37 and 45 percent of physicians, according to a report from the American Medical Association, and often can limit career growth and restrict physicians' ability to provide care in economically or socially marginalized communities.
Here are three leaders' thoughts on noncompete contracts:
Editor's note: Responses have been lightly edited for clarity and length.
L. Dade Lunsford, MD. Physician and the Lars Leksell Professor and Distinguished Professor at the Department of Neurological Surgery at the University of Pittsburgh: [Noncompetes] are certainly widespread among regional competing medical centers and are a known component of current contracts. Many have specific geographical restrictions so that a violation would be employment by a competitor within a certain mileage of any hospital or healthcare facility of the currently employed physician. This requires some physicians to move outside of a wide region in hospital systems that have multiple healthcare entities scattered over a wide geographic region. Thus, when a physician resigns, the noncompete enforcement can be very disruptive not only to providing healthcare for that doctor's patients but disruptive to his family as they will need to move. Hospitals believe that the patients cared for by their doctors belong to the hospital, not the doctor providing care. In fact, most patients still select their healthcare providers based on the doctor, not the doctor's employer.
Matt Mazurek, MD. Assistant Clinical Professor of Anesthesiology at St. Raphael's Campus of Yale New Haven (Conn.) Hospital: I think [with regard to] productivity and work expectations, unions could assist with that. I think that's one of the reasons why residents have been pushing more for unions than attending physicians. The other thing, too, is that we used to be able to be patient advocates when we were in charge. If we lacked the resources to take care of a patient when we were in private practice, we could say, "If we don't get this equipment, we can't take care of the patients." If you're a surgeon or a specialist, you can just take your business elsewhere. If they didn't feel like they could provide the standard of care with the resources being provided, then they could move on.
Now, they can't do that. Now, they're stuck with things like noncompete clauses, which really have physicians with their backs against the wall. I also think that with the union, some of these noncompete clauses may even flat disappear. I think that there's a drive for us to regain some of the control that we once enjoyed, and I think a union is the best vehicle to do that. It's the only vehicle really left. Unionization is also one of those last resorts; there are obviously bad aspects to being unionized, and they're well known and documented, but the benefits often far outweigh some of the risks and some of the negative attributes of being unionized.
James Tinsley, MD. Family Physician at Lighthouse Direct Primary Care (Newport News, Va.): As a family physician, I went under twice with high enrollments of Medicare patients and had to leave the practices with outrageous noncompetes — once with a 35 percent Medicare empanelment and the other with a 55 percent empanelment. If you have an older car, it costs more to repair because there is more wrong with it and the mechanics have to spend more time repairing the older car. So why aren't MDs paid more to care for the elderly? My children can no longer afford for me to accept Medicare, so I opted out.