C. M. Forleiter1, A. M. Al-Ayoubi1, R. J. Chouake1, M. Barsky1, S. Rehmani1, F. Y. Bhora1 1Mount Sinai School Of Medicine,Mount Sinai Roosevelt Hospital / Department Of Thoracic Surgery,New York, NY, USA
Introduction: Several significant concerns have been raised regarding restrictive covenants (RCs) and their impact on the medical profession. The purpose of this research is to assess the understanding of the current residents and raise awareness about this important topic.
Methods: An anonymous electronic survey was sent to all 432 residents at a tertiary hospital in New York City. The survey was comprised of 30 questions including demographics, a pre-test, educational material, and a post-test to assess trainees understanding of restrictive covenants, and their impact on physicians’ jobs, lives, and patients’ care.
Results: There were a total of 115 responses (27% response rate) across all the major residency programs. Overall, 45% of residents were not even aware of restrictive covenants prior to this survey and 87% of residents have received no formal education in employment contracts in medical school or residency. After a short pre-test followed by educational material, the overall percentage correctly answered improved on every question asked on the post-test (see chart). 94% of residents were concerned about a geographic and/or time restriction should they change jobs and 90% thought having to relocate would affect them significantly, citing patient relationships, referral patterns, spouse’s career and children’s schooling as reasons. Over 80% of residents never discussed contract negotiations with an Attending mentor and 83% did not know physicians could bargain RCs out of their contracts. Most residents polled think restrictive covenants damage the physician-patient relationship (84%) and do not belong in a profession like medicine (71%). Lastly, almost all respondents will pay more attention to restrictive covenants when signing their next contracts (76%).
Conclusion: There is a considerable lack of awareness and discussion among medical trainees regarding restrictive covenants. Residents feel RCs have the potential to significantly affect the practice of physicians and limit patients’ access to their doctors. With just a little educational material, residents across all specialties polled were able to demonstrate understanding and almost all seemed concerned that RCs would negatively impact their lives, both personally and professionally. Further assessment from the larger medical community is warranted, with a heavy emphasis on education.
