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What Does At-Will Employment Really Mean for Your Private Practice?

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At-will employment can create confusion for physicians, staff, and practice owners alike. It’s a term that seems straightforward - until you actually start to break it down.

The widely accepted definition of at will employment is when an employer has the right to terminate an employee at any time, for any cause, with or without notice (though that last part is up for debate).

Ok, sure. But what does that mean for your practice?


What Does At-Will Employment Really Mean for Your Private Practice?


Employment Rights & Contracts

Staff employed in an at-will private practice can be fired “without cause”, however, they still have employment rights. Generally, termination without cause must also be within reason.

Contracts limit reasons for which an employee can be fired. If there is a signed contract, the terms MUST be followed to ensure legal termination.

Implied contracts further muddy the waters. Implied contracts are an employer’s spoken statements that imply a staff member will remain employed until certain criteria are met.


Impact of At-Will Termination on Your Employees

While you CAN fire employees “without cause,” it’s usually not in your best interests to do so. Termination can negatively impact the work environment and culture, which affects productivity and trust in company leaders.

The key is communicating openly with all employees regarding terminations, and filtering out emotion as much as possible when making the decision to terminate.


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Things You CAN’T Fire People For, Even in At-Will States

The definition of “at-will employment” would suggest you can fire your staff for anything at any time. However, there are two big exceptions.

1. Discrimination

You cannot legally fire an employee for any reasons that may be considered discriminatory, as outlined by the protected classes in the U.S. Equal Employment Opportunity law. This includes:

  • Age
  • Gender
  • Race
  • Ethnicity
  • Religion
  • Color
  • Disability
  • Pregnancy
  • Military status
  • Sexual orientation
2. Public Policy

You cannot fire a staff member for any reason that violates public policy, or in retaliation against an employee who follows public policy. This includes:

  • Reporting illegal acts (whistle-blowing)
  • Refusing to participate in illegal acts
  • Exercising their rights
  • Following policy guidelines

Employees must feel safe abiding by the law and exercising their rights in your private practice.

In the case of whistle-blowing specifically, the Sarbanes-Oxley Act of 2002 protects employees who report wrongdoings from employer retaliation.

3. Exercising Labor Rights

Finally, an employee cannot be legally terminated for exercising his or her rights under acts such as the Family Medical Leave Act or the Fair Labor Standards Act. These policies give employees certain rights at work:

  • FMLA: the right to take unpaid leave for qualifying family or medical reasons.
  • FLSA: establishes minimum wage, overtime pay, exemption status and accommodations for nursing mothers.

These are only two common acts that come up in at-will employment disputes. There are plenty of other policies that conflict with at will termination.


Handling Employee Termination in Your Private Practice

For good reason, termination of employment is highly nuanced and each case is reviewed on an individual basis.

To make sure you’re within your legal rights to terminate an employee, it’s best to follow good HR practices and consult with a trained HR professional or labor attorney to avoid common pitfalls.

If you’re not sure whether your case falls under the “without cause” designation, or you need assistance preparing your case for a potential (or inevitable) legal dispute, you may benefit from healthcare human resource management or compliance and liability services.


Related: How Much Do Physician Credentialing Services Cost?


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