Physician Compensation Targeted by the Department of Justice

healthcare business change in ownershipBy: Jeff Cohen

The DOJ reported on August 5th a settlement with a South Carolina hospital concerning physician compensation.  Though certainly not the first or the biggest case of its kind (e.g. note the Halifax Hospital and North Broward Hospital District cases, which generated settlements of over $100M and $60M respectively), it’s attention grabbing nonetheless.

The SC case was brought by a whistleblower, a neurologist formerly employed by the hospital.  The doctor alleged that the seven year employment agreements violated Stark and the Anti Kickback Statute because the compensation was more than what was legally permissible and was also based in part on ancillary services ordered by the employed doctors.  Seasoned readers will understand that the concept of “fair market value” (FMV) is at the heart of regulatory compliance and also that compensation surveys of organizations like the Medical Group Management Association (MGMA) are important guides in term of what is/is not FMV.  In the SC hospital case, compensation met or exceeded the top 10% of similarly qualified physicians in the area, which is very interestingly noted by the DOJ (because some of the comp levels were still within the MGMA surveys).  In other words, the trend here is for the Feds to push back against comp levels on the high end of the FMV spectrum. Continue reading

Marketing: Boldly Going Where No Practice Has Gone Before

By now, every physician has learned about ACOs, Super Groups, IPAs and the like. Virtually every “new” acronym and idea has revealed itself as a retread old one, so at least physicians are getting more comfortable with the new language of healthcare reform. And they are accepting that no one really knows what’s going to happen and how medical practice will ultimately be years from now.
Nearly every physician has asked in the past year or so “What do I do now?” And they have heard responses from every vendor which translates into “Buy my stuff.” Ask an IT person what to do…”Buy my stuff.” Ask an EMR person what to do…”Buy my stuff.” Ask a lawyer….ok enough.

What to do and when to do it in light of feared changes in healthcare is anyone’s guess. There is, however, one remarkably overlooked area of business which physicians have traditionally neglected and which they must focus on now more than ever—marketing.

Do you have a website? Do you know what SEO is and how it works? Do you believe that patients buy what you do and not just who you are? In the internet age when people buy mattresses online, sight unseen, physicians have to begin to learn about marketing.

Though years ago, practicing medicine was clearly a profession, it is now big business. And physicians who thrive will be those who embrace business practices, including marketing. This takes a huge shift in perception since most physicians look at marketing as an expense, not as a good investment.

If you were told that every dollar invested in marketing will yield five dollars in new business would you spend the money? If you were told that buying a stock will result in a five-fold yield over twelve months, would you invest? Physicians have to look as marketing as a good investment rather than simply as a cost. And those that do will likely grow and thrive.


Doctors, Take a Lesson from Lawyers: CYA

Lawyers are trained to document every conversation and communication in writing.  In its dimmest light, it is simple CYA.  More generously, putting things in writing ensures that everyone is on the same page and that time and faulty memory doesn’t distort things. It’s hard enough to communicate let alone remember communication!  Doctors have to learn to put things in writing more.

Admittedly, putting things in writing takes time and can be viewed as hostile.  Culturally, while lawyers are used to putting things in writing and don’t take that personally, the same may not be true in the world of healthcare.  Still, documenting in writing conversations and agreements between people can go a long way to avoid liability and conflict.

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New Prescription Pad Laws Effective July 1, 2011

Effective July 1, 2011, physicians and pharmacies (should) have been notified by the State of Florida of a new law requiring the use of counterfeit-proof script pads for controlled substances. Orders on a generic prescription pad will not be honored by the retail pharmacies. For additional information about counterfeit-proof pads and vendors follow the links below: http://www.doh.state.fl.us/mqa/counterfeit-proof.html