Definition of Democracy in Emergency Medicine Practice

Revised January 2021

Reaffirmed April 2014

Originally approved June 2008


Emergency medicine democratic groups are defined by their governing structure which should be in writing and available for review by potential new members.

Democratic groups should be governed by a body that is subject to change by fair and transparent elections that embody a one-vote-one-person structure and philosophy or a representative vote recognizing equity ownership/seniority within the group.

The governing body (or the electorate) should have complete control over the finances and decision making in the group. Financial equity in the group should be structured in such a manner that a new member has a realistic set of expectations as to his/her potential costs, liabilities, and benefits before making the decision to join the group.

All members/owners of the group should have:

  • a right to petition the governing body for redress and grievances;
  • access to a fair due-process procedure;
  • freedom to speak (within the business confines of the group and in a non-disruptive manner) that should be exercised without fear;
  • an equal and realistic ownership opportunity within the group;
  • equal opportunity for management positions within the group;
  • a transparent environment including unencumbered access to individual physician billing information; and
  • compensation that reflects fair market value for services provided.

With democracy, there comes obligation; there is a fiduciary responsibility to the group and an ethical responsibility for all members/owners.

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