Compensation Arrangements for Emergency Physicians

Revised April 2021, April 2015, April 2002, June 1997     

Reaffirmed October 2008, April 1992     

Originally approved June 1988

The American College of Emergency Physicians (ACEP) supports the following general principles for compensation arrangements for emergency physicians.

• ACEP recognizes that emergency physicians practice under a variety of compensation arrangements, eg, independent contractor, fee for service, salary, hourly compensation, percentage of gross or net billing, or a combination of these.
• ACEP recognizes that quality emergency medical care is provided by physicians under different methods of compensation. Specific arrangements may also include performance incentives based on measures such as productivity, patient experience¹, and other measurable variables.
• ACEP recommends that emergency physicians receive timely feedback on any performance-based measures used to determine compensation.
• Regardless of the compensation method or practice arrangement, emergency physicians are entitled to fair and equitable compensation, taking into account their experience, clinical and administrative services provided, added value to the practice, market conditions, and other appropriate circumstances or factors.
• Emergency physicians are entitled to and should be provided detailed itemized reports of all billings and collections in their name on at least a semi-annual basis regardless of whether or not billing and collection is assigned to another entity within the limits of state and federal law and have the right to audit such billings, at any time without retribution. The emergency physician shall not be asked to waive access to this information.
• Emergency physicians should understand their employment agreements and should consider obtaining review by legal counsel prior to signing a contract.
• ACEP strongly urges each emergency physician to carefully evaluate and understand the health care delivery system such that they are engaging in a suitable compensation arrangement.
• ACEP strongly urges transparency in disclosure of both the revenue and expenses associated with an emergency medicine practice, including administration and management services, so that each emergency physician can make an informed decision in determining what is a fair compensation package for them.

¹ American College of Emergency Physicians. Patient Experience of Care Surveys (policy statement). Approved by the Board June 2016.