Entries Tagged 'Physician' ↓

You’ve just entered into a new medical practice partnership and everything seems great. But as the seasons change, differences will likely develop among the medical practice partners regarding both short and long term goals along with management styles.

While there’s no sure-fire way to prevent a bad medical office breakup, you can reduce the pain if you put as many ground rules as possible in writing from the very beginning. It can be time consuming and an otherwise difficult conversation to have with your colleagues, but it’s a conversation that needs to happen. It won’t just help with the break-up, but will also help with the medical practice’s operations. Thus, consider carefully drafting your medical partnership operating agreement and address the following:

-Each partner’s initial investment and percent of ownership
-How salaries will be paid
-How profits & expenses will be handled
-Fringe benefits, vacation time and CMEs
-Call Coverage
-Staff hiring procedures and decisions
-Marketing
-How disputes will be resolved (both large and small)
-Who has check-signing authority
-A termination clause
-If a noncompete is executed, be sure it is thorough and clear
-How the practice will be valued

By implementing a detailed operating agreement, you can avoid problems that come from lack of communication and planning in a busy medical practice.

Every now and then, I think it’s a good idea to take a look at (extremely) bad consequences for health care professionals spawned by unethical behavior. Thus, I share with you the following article that flashed across my desktop recently.

Costa Rica-based online pharmacy charged with racketeering, fraud in U.S.

The Associated Press
Published: August 2, 2007

SAN DIEGO: Physicians and executives are among 18 people accused of selling prescription drugs over the Internet to people without any examinations, according to an indictment unsealed Thursday that charges them with federal racketeering.

The 313-count indictmentmarks the first time organized-crime statutes designed to combat drug cartels and mafia rings have been used to charge anyone with selling prescription drugs over the Internet, said Lauren Mack, a spokeswoman for U.S. Immigration and Customs Enforcement.

AffPower, a Costa Rica-based company, took more than 1 million orders for legal pharmaceuticals including diet pills, birth control pills, Prozac and Viagra between August 2004 and June 2006, according to the indictment. It says the total value of the drugs sold exceeds $126 million (€92 million).

A network of affiliated Web sites received a cut of fees in return for each order forwarded to AffPower.

The indictment names doctors and pharmacies along with AffPower executives and recruiters.

Doctors, who were paid $3 (€2.20) for each order reviewed, approved hundreds or even thousands of orders a day, the indictment says. The prescriptions were then filled through licensed online and brick-and-mortar pharmacies, who received between $5 (€3.66) and $13 (€9.51) for each order.

The indictment, unsealed in federal court in San Diego, names three doctors licensed in Georgia, Kentucky, Ohio and Massachusetts and pharmacists in Colorado and Florida.

The defendants were charged with multiple counts of racketeering, money laundering, mail fraud, drug distribution and conspiracy. The charges carry up to 20 years in prison and millions in fines.

At least 11 of the defendants were arrested earlier this week in five states, Mack said.

Efforts to locate an AffPower Web site or phone number were unsuccessful. Two federal officials said they did not know of a company contact.

Hopefully two things popped up in your head after reading the article: (1) It’s much better to practice ethically and (2) people do have it worse than you.

You can read the original article here.

When a physician becomes part-owner of an established medical practice, many documents can be used to evidence the purchase. The purchase agreement is one of these documents and should include the physician’s ownership percentage, purchase price, and payment terms. This document usually provides representations and warranties by the seller and the practice, in order to disclose pertinent information about the practice being bought into, such as:

(a) assets and liabilities of the medical practice;
(b) current standing with the state’s medical board;
(c) current standing with the IRS and other tax entities;
(d) all exhibited documents reflect the medical practice’s history;
(e) all billing has been done in compliance with CMS and other law; and
(f) the purchase agreement does not violate any other agreements which the medical practice may be bound.

Don’t let your enthusiasm for “arriving” in your medical career interfere with proper procedure.

Before I opened up my private law practice, I negotiated a physician-hospital joint venture. The administration-physician rivalry showed up during dinner with the hospital CEO and he made it pretty clear what his answer to this post’s title would be.

As the son of two physicians, I have a genetic bias but I do see both sides. Regardless, I believe enough law exists to prevent physician-hospital joint ventures that the rivalry becomes less of an issue getting the deal done and providing more medical services to the community.