The Healthcare Employment Reality
Healthcare is an industry often perceived as relatively stable and resilient to economic shocks. Yet, although the industry may offer predictable rewards, there is a misconception that healthcare roles themselves offer inherent job security.
Massachusetts has one of the most healthcare-centered markets in the country. Nevertheless, workers need to be aware that professional status generally does not insulate workers from their employer ending their employment.
Massachusetts is an “At-Will” State: What is “At-Will” Employment and What are the Exceptions?
Massachusetts is an at-will state. In simple terms, this generally means that either party can terminate the relationship at any time, for any legal reason, or no reason at all (however, there are exceptions). For example, and without limitation, there are exceptions that protect against discrimination based on sex, gender, age, pregnancy, disability, etc. There are also protections against retaliation, breach of contract, and bad faith termination of employment contracts to deprive employees of earned compensation such as commission or bonus, and many other exceptions.
Who Is Truly At-Will in Healthcare And Who May Not Be?
Many clinicians are generally at-will employees, meaning they can be terminated at any time, although they may be protected by anti-discrimination, anti-retaliation laws, and/or other laws or exceptions.
Contract employees, such as hospital employed-physicians, medical directors, and department heads, often sign written agreements defining term, pay, duties, and termination standards. These may provide greater protection, potentially allowing for breach-of-contract claims if violated.
Independent contract positions may not comply with the Massachusetts Independent Contractor Statute, Massachusetts General Laws Chapter 149 Section 148B, and a worker classified as an independent contractor should speak with an attorney to evaluate if they are misclassified.
Academic faculty may be at-will or have some job security , depending on the nature of their position, if they have a contract with their employer and based on other factors.
How do you know if you are in an at-risk category?
- Many physicians, advanced practice clinicians, and healthcare administrators in Massachusetts are at-will employees or working under contracts that still allow broad termination rights. If you are in this category, you may be at risk.
- Although you may be an at-will employee, you may have potential claims and rights, depending on your position, the circumstances, and the reason for your employer ending your employment.
Protections for Healthcare Workers: The Legal Constraints of At-Will Employment in Massachusetts
Key Massachusetts Protections for Healthcare Professionals
Unlawful Termination
In Massachusetts, healthcare workers often are protected by statutory and public-policy safeguards. Anti-discrimination protections under Massachusetts General Laws Chapter 151B and federal law prohibit discrimination and harassment and bar retaliation.
FMLA and PFMLA Protections
Family and medical leave rights under the Massachusetts Paid Family and Medical Leave law (Massachusetts General Laws Chapter 175M) and the federal Family and Medical Leave Act often protect eligible workers who take approved leave. Employees may also request disability accommodations.
Public Policy Exceptions and Healthcare Specific Protections
Healthcare employees may also be protected when reporting patient-safety concerns, compliance violations, or fraud.
How Contracts, Policies, and Hospital Practices Can Change the Picture
In Massachusetts, healthcare professionals do not always look beyond their at-will status. A closer look can reveal that contracts, policies, and hospital practices may offer more protection. For example:
- A written physician contract may require “cause” for termination or provide notice and cure provisions that limit an employer’s discretion.
- Employee handbooks may create enforceable obligations.
- Credentialing and peer review processes, particularly in hospital settings, may impose procedural safeguards that may be required to be followed before privileges or employment are terminated. Likewise, established progressive discipline policies may constrain abrupt dismissal.
- Inconsistent enforcement of policies or informal assurances from supervisors may also become legally relevant in a dispute.
At-Will Employment Doesn’t Rule Out Options
At Maura Greene Law Group, we are advocates for healthcare professionals navigating unfair treatment.
If you are facing uncertainty in at-will employment, contact our employment attorneys at the Maura Greene Law Group for a confidential consultation, or call us at (617) 936-1580.
The Not So Fine Print:
Every case has its unique facts. Before you take any action, you should contact an employment lawyer and get advice on your own situation. We can’t provide legal advice here, and this isn’t intended as legal advice. It is best, if possible, to establish a relationship with an attorney before a workplace issue turns into a crisis.