Over the last decade, the shift from independent to employed/integrated practice has prompted concerns regarding restrictive covenants and non-compete clauses included in physician contracts. Not only do individual states have their own guidelines, but the potential benefits must be weighed against the potential risks to patient care, clinician well-being and the broader goal of achieving the quadruple aim.

In response to these concerns, the ACC Board of Governors has developed a white paper designed to be a resource for ACC members and their Chapters, in conjunction with legal counsel, on various aspects of the restrictive covenant issue. The white paper, which does not constitute official ACC policy, includes results from a survey of physician members by the BOG and MedAxiom along with an overview of legal perspectives, the current status of restrictive covenants in individual states, and a closer look at potential reasons to either retain restrictive covenants and/or restrict or eliminate them.

“Reasonably written restrictive covenants may facilitate practice expansion into new geographies, protect the clinical and business enterprises of the group or health system, and foster training and mentorship of new partners,” the authors write. In addition, “restrictive covenants may also protect the public from the loss of specialty physicians in underserved areas and ensure that physicians are available for emergency cardiac care in specific communities.”

However, the authors also note that “several arguments exist in favor of eliminating or limiting restrictive covenants.” Among the concerns: potential negative impacts on contract negotiations, patient access to care, and progress towards meeting the quadruple aim and improving clinician well-being. According to the paper, the majority of BOG and MedAxiom survey respondents supported ACC Chapters advocating for legislation that would “limit or ban restrictive covenants.”

Download and read the complete white paper.

Download a chart with information on restrictive covenants by state.

Clinical Topics: Cardiovascular Care Team

Keywords: Policy, Physicians, Patient Care, Surveys and Questionnaires, Health Services Accessibility, Negotiating, Mentors, Goals, Medically Underserved Area, ACC Advocacy

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