Physician Practices

DOXIMITY STUDY SHOWS UPTICK IN PHYSICIAN DEMAND AND COMP IN 2017

December 29, 2017 | Little Health Law

medical-doctor-1314903-m1 Earlier this month, Doximity released a new study that provides a national review of physician compensation information and job trends, as the strong trend of physician employment by hospital systems continues. Doximity, formed in 2011, is “the largest community of healthcare professionals in the country,” according to its website. More than 70% of physicians in the United States are verified Doximity members. Doximity is a network of physicians and other healthcare practitioners. Doximity’s membership also includes many nurse practitioners, physician assistants and pharmacists. More about Doximity can be learned from its website, www.doximity.com.

The study analyzes thousands of job advertisements posted in 20 of the nation’s largest cities and involving 15 common medical specialties. Compensation growth was calculated using self-reporting from compensation surveys of tens of thousands of full time U.S. physicians. Physician compensation grew 5.1 percent in 2017, according to the study.

The Exit: Terminating Physician Employment Agreements

November 28, 2017 | Little Health Law

to-sign-a-contract-2-1221951-m All good things must end. Every employment relationship will end sooner or later, one way or the other. While it is obviously important that parties to an agreement convey on the front end of the relationship positive feelings, the exit strategy should never be disregarded in one’s planning or evaluation of contractual terms. Life happens. Things can change one’s desire or ability to be in a deal, a contract, or an employment relationship. Therefore, while perhaps it may feel counterintuitive to dwell on how to end a relationship just as you are forming it, the termination provisions are very important and, sometimes, critical.

Georgia Medical Practice Lawyers

Most physician employment agreements will articulate a specific term, typically one to five years. Often a physician employment agreement will contain an auto-renewal provision so that, following expiration of the initial term, the relationship is continued from year to year automatically absent timely advance notice of non-renewal by employer or employee. From the medical practice’s standpoint, the right objective is usually to incent longevity and continuity of the relationship with the physician, while preserving a way out of the relationship if needed. Physicians, on the other hand, usually desire stability and sometimes a feeling that employment is “guaranteed” absent real cause to terminate the relationship. In the typical written physician employment agreement, how the agreement will end is determined by term and termination provisions.

PHYSICIAN NON-COMPETE AGREEMENTS

October 24, 2017 | Little Health Law

1221952_to_sign_a_contract_3 Virtually every week, our business and healthcare law firm is engaged to provide advice and assistance concerning a physician employment agreement, either as counsel to the physician or for an employer/hospital or medical practice. “Restrictive covenants,” including non-competition agreements, are desired by the majority of employers and therefore included in their proposed form of employment agreement. Physicians most often prefer, however, if they had their druthers, not to be restricted in their ability to work following the expiration or termination of a job. Hence this section of the proposed employment agreement, particularly those with more broad and onerous non-compete provisions, can be the source of tension on the front end of the employment relationship. Restrictive covenants also show up in a variety of other contractual arrangements, including medical practice ownership agreements (e.g., shareholder agreements, operating agreements), joint venture contracts, and medical director agreements.

Pharmaceutical companies will be required to provide additional opioid training for prescribers

September 5, 2017 | Little Health Law

medical-doctor-1314902-m The FDA has announced that it will begin requiring opioid manufacturers to provide more training for healthcare providers. At present, manufacturers must provide training about long-acting, extended release opioids to prescribers. In the future, the manufacturers of short-term and immediate release opioids will also be required to provide the same type of training. The training will be available to physicians, nurses, and pharmacists.

This change was brought about by the continuing high rate of drug overdose incidents by prescription drug abusers, particularly those abusing opioid painkillers. The training was previously only required by makers of long-acting opioids. However, the FDA stated statistics show that today the vast majority, 90% to be exact, of opioid pain medication prescriptions are for the short-acting variety. It has been found that abusers of opioids are misusing the short-acting, immediate release versions as well as the long-acting types. After becoming addicted to the commonly prescribed short-acting versions of the medication, most abusers graduate to higher doses of the prescription drugs or move to illegal drugs, which present a lower cost alternative.

Interstate Medical Licensure Compact: Will Georgia physicians soon be able to share their expertise with more patients?

July 14, 2017 | Little Health Law

861958_hidoc-on-white Georgia physicians seeking licensure in other states hope to benefit soon from a more streamlined process. In fact, a bill was recently introduced in the Georgia House of Representatives to allow Georgia to join the growing number of states participating in the Interstate Medical Licensure Compact. (House Bill 637). Such a bill, if passed by both houses of the legislature and signed into law by the Governor, would greatly simplify the process for Georgia physicians to obtain licenses in other member states, allowing a wider population of patients access to their services and expertise. This type of bill would not change the existing methods of obtaining a license in Georgia but would provide an additional route. Although the bill was not voted on, the effort indicates this type of change may be on the horizon.

U.S. Opioid Crisis and the Effects on Pain Management Clinics

June 30, 2017 | Little Health Law

pills-2-300x225 The United States only holds about 5% of the world’s population yet is consuming 99% of the word’s hydrocodone, 80% of the world’s oxycodone, and 65% of the world’s hydromorphone; all powerful narcotics. Those statistics show themselves in the most disheartening of ways with an opioid epidemic that has 1.3 million Americans needing hospital care for opioid related issues and over 30,000 dying from opioid overdoses in one year alone, with the number climbing every year. The nation’s opioid crisis also costs the U.S. over $70 billion a year when accounting for healthcare costs, productivity loss, addiction treatment and the costs of criminal justice actions and resources. The nation’s epidemic has garnered a federal response in the form of CDC guidelines that are discouraging primary care physicians from prescribing opioids as a first line of defense (or only line of defense) for patients with chronic pain and instead encouraging the use of non-opioid and even non-drug treatments for pain. A DEA response shortly thereafter indicated production quotas would be enforced for Schedule II pain medications, reducing the production of some medications by a quarter or even a third.

AMA Announces Physician Ownership of Medical Practices Drops Below 50%

June 13, 2017 | Little Health Law

medical-doctor-1314903-m1 Traditionally a hallmark of success for many physicians, physician ownership of medical practices continues to decline, for now, according to a recent study by the American Medical Association (AMA). The AMA recently issued the results of a survey, entitled Policy Research Perspectives, Updated Data on Physician Practice Arrangements: Physician Ownership Drops Below 50%.

Physician and Medical Practice Attorneys

The survey evaluated, among other things, whether physicians fall into one of four categories as to a physician’s “main” practice: (1) whether the physician is an owner, employee, or independent contractor of the medical practice; (2) the type of medical practice; (3) ownership structure of the practice; and (4) how many physicians are in the practice. The information and data reviewed spanned the period from 2012 to 2016. The survey results confirm a continued trend favoring employment and larger practices. 2016 was the first year with survey results demonstrating that less than half of practicing doctors (about 47%) own their own practice. Surveying over 30,000 physicians, the survey excluded physicians who work less than 20 hours/week providing patient care or are Federal employees.

NO TO OPIODS: GRANTING PATIENTS CONTROL OVER THE USE OF PAIN MEDS IN THEIR CARE

April 3, 2017 | Little Health Law

1238683_untitled Prescribing opioids for pain can be a routine part of medical treatment, however, opioids are a national dilemma and though patients may need them for pain management, they are also highly addictive. Some patients being administered these prescriptions are recovering from opioid addictions and face a high-risk of relapse. And, because some more unscrupulous health care providers use “pill mills” to make money, there is a strong push in many states to protect patients. This push has brought about a new idea – patient directives that notify providers NOT to prescribe or administer opioids to them.

Medical Practices Beware Risks that Attend Improper Classification of Contracted Physicians

March 20, 2017 | Little Health Law

medical-doctor-1314903-m1 Many medical practices and health care services businesses confront circumstances in their business model that justify unique and flexible arrangements with physicians to meet healthcare delivery needs (e.g. call coverage). Unique situations for health care delivery models lead to creative employment situations that may prompt evaluation of whether treatment of physicians as independent contractors (versus employees) makes business and financial sense. Too often, this issue is evaluated short shrift, however, leaving the owners of a medical practice unknowingly exposed to serious financial risks that could have been avoided.

Georgia and South Carolina Medical Practice and Physician Employment Attorneys

As with many legal considerations, factual details matter. Therefore, each situation should be examined independently giving due regard to specific facts, rather than relying upon general legal notions one has heard. Each medical practice employer’s situation is inherently different to some degree. Given the fact driven analysis required, what one practice does may not be reliable for another practice. Therefore, medical practice owners and decision makers should not defer too much to what is heard about what others do; others may be wrong. With regard to the question of whether a contracted physician can be properly treated as 1099 versus W2, it is best for a medical practice to consult with its law firm and permit the law firm to fully evaluate the details.

Fraud and Abuse Update: DOJ Announces $11.75 Settlement with Costco of Alleged Pharmacy Fraud

February 1, 2017 | Little Health Law

hammer-to-fall-673264-m On January 19, 2017, the United States Department of Justice (DOJ) issued a press release announcing a deal reached with Costco Wholesale to resolve DOJ’s disputed allegations that Costco violated Federal law in filling prescriptions by lax protocol. The allegations against Costco stem from an investigation by the United States Drug Enforcement Agency (DEA) Diversion Groups based in Seattle, Los Angeles, Sacramento and Detroit.

Georgia Healthcare and Business Litigation Law Firm

Our Atlanta and Augusta-based business law firm closely follows healthcare industry legal developments, including the healthcare fraud and abuse matters. A strong focus of the DEA and supporting Federal and State law enforcement activities is the current epidemic of Opioid abuse in the United States. According to the United States Centers for Disease Control and Prevention (CDC), deaths from Opioid overdose in the United States have quadrupled since 1999; and during the same period, sales of these drugs quadrupled. The most common such Opioids are Methadone, Oxycodone and Hydrocodone. “Pill mills” are a principal target of DEA and State law enforcement efforts. To combat pill mills and other circumstances that may give rise to misuse of opioids and controlled substances, the DEA will pursue healthcare providers and entities that fail to strictly follow legal protocols in prescribing or dispensing controlled substances.