Originally approved June 2023
The American College Emergency Physicians (ACEP) believes the physician-patient relationship is the moral center of medicine. The integrity of this relationship must never be compromised. The physician must have the ability to do what they believe in good faith is in the patient's best interest.
Medical decisions must be made by physicians, and any practice structure that threatens physician autonomy, the patient physician relationship, or the ability of the physician to place the needs of patients over profits should be opposed. Corporate practice of medicine prohibitions are intended to prevent non-physicians from interfering with or influencing the emergency physician’s professional medical judgment.
The following clinical decisions that impact patient care should only be made by an emergency physician or a nurse practitioner/physician assistant under supervision in accordance with ACEP policy:
These decisions, if made by other individuals or entities, would constitute the unlicensed practice of medicine if performed by an unlicensed person.
In addition, the following business or management decisions that result in control over the emergency physician’s practice of medicine should only be made by a physician. Under corporate practice of medicine prohibitions, these decisions made as part of the operations and management of an emergency medicine group practice must be made by a physician, physicians, or under the direction of a physician on behalf of the group practice, but not by each individual physician or by an unlicensed person or entity:
These types of decisions cannot be delegated to a non-physician, including non-physician staff in management service organizations. While a physician may consult with non-physicians in making the business or management decisions described above, the physician must retain the ultimate responsibility for, or approval of, those decisions.
Ownership of medical practices, operating structures, and models should be physician-led and free of corporate influence that impacts the physician-patient relationship.
The following types of medical practice ownership and operating structures would likewise constitute the prohibited corporate practice of medicine: