Physician Employment by a Nonphysician Supervisee

Download PDF

Physicians’ relationships with midlevel practitioners must be based on mutual respect and trust as well as their shared commitment to patient well-being. Health care professionals recognize that clinical tasks should be shared and delegated in keeping with each practitioner’s training, expertise, and scope of practice. Given their comprehensive training and broad scope of practice, physicians have a professional responsibility for the quality of overall care that patients receive, even when aspects of that care are delivered by nonphysician clinicians.

Accepting employment to supervise a nonphysician employer’s clinical practice can create ethical dilemmas for physicians. If maintaining an employment relationship with a midlevel practitioner contributes significantly to the physician’s livelihood, the personal and financial influence that employer status confers creates an inherent conflict for a physician who is simultaneously an employee and a clinical supervisor of his or her employer.

Physicians who are simultaneously employees and clinical supervisors of nonphysician practitioners must:

Give precedence to their ethical obligation to act in the patient’s best interest.
Exercise independent professional judgment, even if that puts the physician at odds with the employer-supervisee.

AMA Principles of Medical Ethics: II, VI, VIII

Read the Principles

Council Reports

PDF Physician Employment by a Nonphysician Supervisee

Related Opinions

See All Opinions

Opinion 1.1.1

Patient-Physician Relationships

At the heart of medicine lie relationships founded in a “covenant of trust” between patient and physician in which physicians commit themselves to responding to the needs and promoting the welfare of patients.

Opinion 10.4

Nurses

Nurses hold a primary ethical obligation to promote patients’ well-being; while physicians have overall responsibility for the quality of care that patients receive, good nursing practice requires that nurses voice their concerns when, in the nurse’s professional judgment, a physician order is in error or is contrary to good medical practice. Physicians’ relationships with nurses should be based on mutual respect and trust.

Opinion 10.5

Allied Health Professionals

Although physicians have overall responsibility for the quality of care that patients receive, allied health professionals have training and expertise that complements physicians’. Allied health professionals share a common commitment to patient well-being. Physicians’ relationships with allied health professionals should be based on mutual respect and trust.