Factors associated with corrective actions, remediation, and employment termination of emergency physicians

Medical professionalism is fundamental to the delivery of high-quality patient care. There is a paucity of data to describe behaviors associated with negative professional and employment outcomes. This study examines common factors leading to corrective actions, remediation, and termination of emergency physicians (EPs).

This was a cross-sectional survey sent to academic chairs in emergency medicine to identify factors for corrective actions, remediation, or termination of EPs. Survey items were piloted and response process validity gathered prior to administration. Data are reported as descriptive statistics.

60 of 167 (36 %) members of the Association of Academic Chairs in Emergency Medicine (AACEM) completed the survey. Most respondents were male (75 %), at least 45 years of age (93 %), had been in practice for at least 20 years (85 %), had 5 or more years' experience as an academic chair (63 %), and had served as chair for more than 60 EPs (70 %). Respondents reported providing corrective action for approximately 700 EPs, remediation for 371 EPs, and termination for 132 EPs. Corrective actions were most common for: disrespecting others (82 %), poor working relationships with nursing (77 %), and insufficient academic output (70 %). Remediation was most common for: disrespecting others (47 %), substandard patient care (43 %), and poor working relationships with nursing staff (42 %). Termination was most common for: substandard patient care (32 %), disrespecting others (23 %), and conviction for illegal activity (22 %).

In this survey of academic chairs in emergency medicine, the most common factors of employment-related corrective actions, remediation, and termination among EPs were related to issues of professionalism. There may be opportunities to address these issues prior to employment termination. Future studies should be expanded to include survey respondents who are not academic chairs in emergency medicine.