The business of healthcare has become increasingly complex over the last ten years, with developments such as the emergence of Accountable Care Organizations (ACOs), the passage of the Affordable Care Act and present uncertainty over its future, and the accelerated implementation of telemedicine.
When you are buying or selling a healthcare practice, even simple, straightforward transactions can become needlessly complex. Miscommunications and misunderstandings over key terms of the transaction can emerge, requiring the parties to spend unnecessary time, energy, and money on attorneys’ fees to resolve disputes. One of the best ways to avoid, or at least minimize, these misunderstandings is through a letter of intent, also sometimes referred to as a memorandum of understanding or a term sheet.
Many physicians, frustrated by the bureaucracy of modern medical practice, the financial pressure to shorten appointments and limit face time with patients, and the delays and hassle of dealing with health insurers for reimbursement, are increasingly turning to concierge medical practices as an alternative. Under this business model, patients pay a set annual fee for unlimited (or nearly unlimited) access to a private primary care physician, many of whom will even make house calls for minor illnesses, injuries and physicals.
When hiring associates, doctors understandably want to limit costs as much as possible. One of the ways in which doctors often try to reduce costs is by categorizing associates as independent contractors, rather than as employees. While classifying an associate doctor as an independent contractor is an appealing option, there can be substantial consequences for improperly categorizing an associate as an independent contractor when they should be categorized as an employee.
The majority of your patients are likely conscientious about honoring appointments, compliant with your treatment decisions, and pleasant with you and your staff. However, every practice has its share of problem patients: those patients who repeatedly no-show to appointments or cancel at the last minute, who refuse to follow even simple instructions, or are just plain difficult to deal with.. Although it is always best to try to work through any issues with the patient, there may come a point when you conclude that it is simply better for everyone to terminate the treating relationship with the patient.
Many dentists, particularly doctors who have recently graduated from dental school, choose to become associates at larger practices, rather than open their own clinic or partner with another dentist. Structured correctly, this can be a mutually beneficial relationship, under which the owner-doctor can increase his or her practice’s client base, revenue, and profitability, while the associate doctor can gain more experience, both in providing direct patient care and in the practical operation and administration of a dental practice, which he or she can then use as a future practice owner.
Owning a practice right out of dental school can be a daunting endeavor. Although dental school may prepare you for clinical practice, often little or no attention is paid to the administrative responsibilities of running a practice. In fact, a 2013 survey conducted by the American Dental Education Association (ADEA) showed 95% or more of graduating dental students believed that their education adequately prepared or well-prepared them in the areas of patient evaluation and diagnosis; radiology; and operative and restorative dentistry, whereas less than half believed their education had prepared them for practice administration.
In previous posts, we covered the ins and outs of HIPAA and its four general rules: Privacy, Security, Breach Notification and Enforcement. In this post, we discuss the Payment Card Industry Data Security Standard (“PCI DSS”), an often overlooked privacy standard that, while overlapping somewhat with HIPAA, is a completely separate set of standards that govern security over your patient’s credit cards.
Every doctor has to deal with unhappy patients from time to time. The proliferation of social media websites such as Facebook, Yelp and Twitter, as well as doctor-specific rating sites like Healthgrades.com, Vitals.com and RateMDs.com have allowed unhappy patients the means to seriously damage your on-line reputation, regardless of the quality of services you provide or the merits of the complaint, and can have a devastating effect on your ability to grow your practice.
In our last two posts we’ve evaluated HIPAA’s Privacy Rule and the Security Rule/Breach Notification Rule, which outline your duties under HIPAA. In our final post in this series, we’re going to take a close look at what happens if you violate, those rules, whether intentionally or inadvertently.