“In any situation where the economic or other interests of the employer are in conflict with patient welfare, patient welfare must take priority,” says a policy statement adopted by the association.

“A physician’s paramount responsibility is to his or her patients,” the association said. At the same time, it added, a doctor “owes a duty of loyalty to his or her employer,” and “this divided loyalty can create conflicts of interest, such as financial incentives to over- or under-treat patients.”

The association is disseminating its policy to doctors at a time when more of them are becoming hospital employees. About one-third of new doctors say they would prefer to be employed by hospitals, rather than practice on their own.