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Collins introduces bill to protect due process rights of emergency room physicians

By Howard B. Owens

Press release:

Congressman Chris Collins (NY-27) and Congressman Raul Ruiz (CA-36) introduced legislation to ensure that emergency physicians’ due process rights are protected if they are employed by a third party contractor. More than half of all emergency physicians around the country are denied due process because standard contracts require them to waive away these rights.

“Emergency departments (ED) are at the core of our nation’s health care safety net, staffed with hardworking physicians who provide care 24 hours a day 365 days a year,” Collins said. “Many hospitals have turned to physician staffing companies to meet complex organizational challenges, although that has come at an unfair cost to ED doctors.

"These hardworking men and women, who spend a decade in school and residency training and dedicate their lives advocating on behalf of their patients, have lost their due process rights. My legislation seeks to fix that.”

“Patients come first. Quality of care and patient safety should be the first concern of any doctor, not whether they could be fired for whistle blowing or reporting dangerous conditions in the hospital,” Dr. Ruiz said. “I am proud to co-author this bill to improve patient safety and cut down on fraud in our health care system by guaranteeing all doctors due process and whistleblower protections.”

Due process, a guaranteed right under the U.S. Constitution, is the foundation of one’s employment status across many industries. Physicians receive due process rights from a number of sources including Medicare, as a condition of participation, and the Health Care Quality Improvement Act of 1986. However, these laws only afford due process rights to physicians directly employed by the hospital.

The third-party staffing model is most common in emergency departments across the country, leaving emergency doctors without the ability to negotiate basic terms of employment. These physicians are required to waive their right to a fair hearing and appellate review by their peers on the medical staff, in the event of termination or a restriction of their practice rights.

For patients, the link between due process and quality care is clear. Physicians are unable to act as their patient’s best advocate when they fear retribution from their employers.

Among the medical community, there is concern that third party contract structures will deter future generations from pursuing a career in emergency medicine and leave our nation with a shortage of emergency room physicians. This legislation has the support of leading organizations in emergency medicine.

"In the field of emergency medicine, there is no greater policy imperative for patient safety and quality care than enacting this due process legislation," said David Farcy, president of the American Academy of Emergency Medicine. "The Academy is proud to stand with Representative Collins and Representative Ruiz, and we applaud them for championing this bill that serves the best interest of the patient and the taxpayer."

“On behalf of more than 38,000 emergency physicians, emergency medicine residents, and medical students, the American College of Emergency Physicians (ACEP) is proud to support Congressman Collins’ and Congressman Ruiz’s legislation to ensure every emergency physician has medical staff due process rights,” said Paul Kivela, MD, MBA, FACEP, president of the American College of Emergency Physicians. “This is an important safeguard that will ensure all emergency physicians have access to a fair due process procedure.”

“The Council of Residency Directors in Emergency Medicine (CORD) represents the over 240 emergency medicine residency training programs in the U.S. CORD strongly supports due process rights for emergency physicians as this is in the best interest of the public, the institutions and the safe practice of medicine," said Christopher Doty, MD, president, Council of Residency Directors in Emergency Medicine.

"Therefore, CORD supports Representative Collins and Representative Ruiz on this important bill."

“Due process legislation will improve patient safety and support our physicians’ focus on providing patient-centered care, which is the hallmark of the osteopathic profession,” said Mark A. Baker, DO, president of the American Osteopathic Association.

“With nearly 10 percent of the nation’s 108,000 DO degreed physicians specializing in emergency medicine, the American Osteopathic Association commends Congressman Collins and Congressman Ruiz for their leadership on legislation that would ensure due process is available to physicians working in a complex practice environment.”

“On behalf of the American College of Osteopathic Emergency Physicians, I am in full support of Representative Collins and Representative Ruiz in proposing this legislation," said Christine F. Giesa, DO FACOEP-D, president, American College of Osteopathic Emergency Physicians.

"Our patients are the core of our work, and this legislation is a major step forward in ensuring their health and safety.”

“The guarantee of due process rights is one of the most critical issues facing emergency physicians and is fundamental to our ethical mandate to act in the best interests of our patients, many of whom are among the most vulnerable in society,” said Steven B. Bird, MD, president of the Society for Academic Emergency Medicine (SAEM). “Therefore, SAEM strongly supports the passage of this legislation.”

"Entering a workforce where due process is ensured is the best possible future for residents and students in emergency medicine," said Mohammed Moiz Qureshi, president of the American Academy of Emergency Medicine Resident and Student Association.

"AAEM/RSA echoes the commitment of Representative Collins and Representative Ruiz to that future and we appreciate their work on this legislation to help future generations of emergency physicians best serve their patients."

“A physician’s duty to advocate for safe and effective treatments, policies and practices is impaired by lack of due process,” said Charles McKay, MD, president of the American College of Medical Toxicology. “ACMT is proud to stand with Representative Collins and Representative Ruiz in this effort to better protect patients’ health and quality improvements within the health care system.”

For a copy of H.R. 6372, click here.

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