At its interim meeting in Honolulu, the American Medical Association House of Delegates approved a set of six principles for physicians entering into employment (PDF). The principles cover, among other things, peer review, payment agreements and addressing conflicts of interest.

Regarding conflicts of interest, the Principles for Physician Employment state that employed doctors should be able to exercise their independent medical judgment and, in cases where the economic interests of the employer are in conflict with patient welfare, "patient welfare must take priority."

Another point states, "Peer review of employed physicians should be conducted independently of and without interference from any human resources activities of the employer." Furthermore, according to the principles, doctors rather than "lay administrators" should ultimately be responsible for peer review of medical services.

"The Principles for Physician Employment provide a broad framework to help guide physicians and their employers as they collaborate to provide safe, high-quality and cost-effective patient care," AMA board member Dr. Joseph Annis said in a news release. "The Principles for Physician Employment add to the AMA's growing range of products and services that help physicians understand and manage their employment and contractual relationships."

Regarding payment, the principles state that employers should defend physicians with respect to any contractual, legal or regulatory violation connected to the employer's billing services that are not the fault of the physician.

The other principles outlined in the document include advocacy for patients and the medical profession, contracting and hospital medical staff relations.