The Federal Trade Commission (FTC) recently that would ban noncompete clauses in employee contracts. My interest was immediately captured when doctors were specifically listed among the professions affected. The American Academy of Family Physicians of family physicians in group practices have noncompete clauses as part of their employment contracts. As more and more physicians from a self-governed practice setting to an employed status practice, a growing number of physicians are impacted by such clauses. I am one of those doctors.
When I was offered my contract during residency 14 years ago, I discovered that noncompete clauses were common for employed physicians. The lawyer who reviewed my contract offer noted that I had a favorable agreement and that some noncompete clauses are much more restrictive. I was told to expect a noncompete agreement in any contract I was offered, and to not bother attempting to negotiate. Removing the noncompete clause would not happen. Given that advice and the fact that I was landing a job within my dream practice in a rural community with colleagues I trained under in medical school, I signed the contract with no regrets to date.
So, why am I emotionally fired up about noncompetes and their enforcement? Although I am professionally and personally fulfilled with my current practice and the community I serve, there are physicians and providers who do not enjoy the same luxuries as me. Noncompete clauses ultimately infringe on physician well-being, which then into suboptimal patient care.
A Difficult Predicament
At the heart of all of this is the physician-patient relationship. I've put forth a great deal of time and effort to build trust with the patients I serve. With every medical decision, if I do not have the patient's trust, the care of that patient will suffer. Many of my patients have shared information with me that they were too afraid to discuss earlier in the timeline of their care. Breaking away from my community would essentially be starting over. I have had new patients tell me stories about how their previous doctor at other practices "disappeared" and they were unable to find them due to the doctor's inability to share with them their new practice location or the fact that they moved away. Granted, this may be an error of interpretation on the patient or past doctor's side, but the underlying current is the fear of enforcement of a noncompete agreement.
So, what if this were to happen to me? If a circumstance arises where I no longer wish to carry on my employment status with my current healthcare organization, I will be faced with a terrible choice. I will have to choose between either: uprooting my family and severing the community bonds I have built within my personal and professional roles; commuting further than the 3.5 miles I currently drive to a clinic outside of my noncompete agreement in a community I have no personal engagement within; or roll the dice and set up a practice in my community and beg for my noncompete clause to not be enforced. I cannot imagine how a fully vested and seasoned family physician could navigate this choice.
I understand there was a time and a place long ago for noncompete clauses. When small physician-owned practices were putting their own sweat equity into building those patient and community relationships, noncompete clauses provided the protection needed to build practice integrity. However, as healthcare organizations have grown, noncompete clauses have carried over and allowed conglomerates to hold physicians hostage to toxic workplace cultures.
A Call to Action to Improve Healthcare Culture
When I read the FTC proposal and saw that it specifically mentioned doctors as an example of employees this rule would affect, I immediately realized this was a physician well-being issue. It is high time this was called out and addressed. Any organizational effort toward fostering a culture of well-being for physicians and patients is meaningless as long as it continues to write noncompete clauses into employee contracts. Rather than putting time and energy into enforcement of a noncompete clause, that same focus could be used to cultivate an environment in which physicians want to stay. The healthcare organization would begin to compete to keep and grow its physician and provider base. The result would be a thriving culture of physicians and staff providing better care for ultimately healthier patients.
My challenge to healthcare leaders is to take a look at your organization and ask yourself if you have a culture in which physicians are looking to join or one in which you are concerned about the FTC's rule being implemented. If you are the former, you should next ask yourself, "Why have we not already disposed of our noncompete contract clauses?" Become a winning organization that competes for physicians and other providers while supporting them as they care for their patients. It would be an easy first step to build trust within your organization by discontinuing the use and enforcement of noncompete clauses. There is little risk of losing healthcare workers to local competition if you are growing a thriving work culture that promotes well-being, and an environment in which physicians want to stay and deliver high quality patient care.
is a family physician in Princeton, Minnesota, and a recent graduate of the American Academy of Family Physicians' program.