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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: 

  1. Give precedence to their ethical obligation to act in the patient’s best interest. 
  2. 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