Monitoring the Changing Beat of Healthcare

Articles


View List

Download File

PHYSICIAN UNIONS -- The Solution or Just Another Problem

By: Steven I. Kern and Robert J. Conroy

Around the state, union organizers are recruiting physicians. These organizers are seeking to capitalize on the frustration and feelings of powerlessness of physicians faced with the challenges of managed care and stiffer competition. As hospitals and mega medical groups set up practice across the street from established community-based practices, and national chains gobble up practices, physicians are looking for some relief. But are unions the answer?

Some physicians, who believe that strength in numbers will be enough, have been quick to embrace unions. They believe that by joining a union they become one of many and will have voice in national and local political debates and have a friend at the collective bargaining table when healthcare benefit packages are negotiated and forms of coverage selected. The theory is that unions with physician members will be hostile to managed care plans and resist negotiating contracts with national employers that encourage employees (the union's members)to select managed care plans for their healthcare needs. But is this realistic? Unions and management have been this nation's biggest supporters of managed care. Indeed, managed care could not have gotten a foothold without their combined efforts to promote cost containment and lobby the federal government to do likewise. Unions, also, run many benefit plans on their own. Each year, organized labor negotiates with carriers, managed care companies and mega-medical groups for the care of union members not covered by employer-based plans. Even if unions could serve as a forum for physicians collectively to bargain with managed care plans (and they cannot as noted below), it would not be in their best interest to do so. Unions have an interest in keeping healthcare costs low, even if that means that physicians will suffer.

But, some believe that the unions of late have cooled on managed care now that they see that managed care may mean rationed care. So, why not join a union and present a united front to managed care companies and bargain for better reimbursement and greater coverage? The simple answer is that physicians who are not employed by the same employer cannot bargain with a single voice on reimbursement or any other economic terms of their care. Federal antitrust law makes it a crime for any group of independent businesses or professionals to bargain collectively for the sale of their goods or services, or to refuse to sell their goods or services to any purchaser. The law refers to such collective bargaining as a "conspiracy to fix prices" and the collective withholding of goods and services as a "group boycott." Both are serious federal offenses and as one group of Arizona dentists can attest, vigorously prosecuted. (These unfortunate and ill-advised dentists were faced with the sobering prospect of having their homes, bank accounts and office equipment seized if they did not plead guilty to federal charges for their part in a "group boycott" of a managed care plan.) There is no blanket exception to the antitrust laws that allows union member physicians to bargain collectively UNLESS they are all employees of the same employer. No matter what the organizers might say, sole practitioners and other self-employed physicians cannot bargain collectively whether they are union members or not.

Is there a place for unions in medicine? Well, the answer to that question is a qualified "it depends." Where physicians find themselves working for an employer--whether after selling their practice to a hospital or some management company, or joining the payroll of healthcare chain right out of residency-a union might be a good idea. Residents and house officers and medical school faculties in some areas have been unionized for years, and they have found unions many times to be an effective counter weight to the arbitrariness of hospital administrators and medical school deans. So, it is only reasonable to expect that employed attendings or other physicians joining the ranks of the salaried will also look to organize. In these settings, a union may make a difference. And for that reason, employers can be expected to resist any effort to organize. Principally, they will charge that the physicians involved are supervisory employees whom federal law does not allow to organize. But, even if they lose on those grounds, they will fight on and challenge each phase of the unionization process. The stakes will be high. If the physicians organize, what is to stop the rest of the staff. It is hard to "downsize" or arbitrarily increase the number of patient "encounters" when a managed care plan lowers reimbursement if your entire staff is organized.

For those physicians who cannot unionize, there are other answers. They need not stand by and be picked off-one by one-- by the managed care plans, mega-groups or chains. Solos and small groups can and, in most cases, should give some thought to merging or forming collective management companies they will allow them to compete better with bigger entities. Physician-owed and -controlled practice management companies are becoming more common and hold the promise of allowing physicians to collectively bargain with managed care plans and suppliers, while reaping the benefits of professional management and marketing they could never afford on their own. Instead of selling out and going to work for some large impersonal company, physicians who set up their own management companies can by "going public" (that is, by selling a small percentage of their companies' shares to the public) get others to invest in their future while they, the physicians, retain control. These physicians are not running away from their patients and all that they have worked for; they are taking responsibility for their own destiny and proving that physicians do have a place in healthcare management.

Also, physicians should not forget that their state and county medical societies are there to help them meet these challenges as they have been in the past. For example, when the PROs and OSHA threatened the practice of medicine who was there: The state and county medical societies. The societies and the state's physician political action committees (PACs) should be rallying points for physicians. Unfortunately, though, too many physicians do not join the societies or contribute to the PACs. Some are turned off by what they believe to be the overtly political nature of the societies or the costs of participation. Yet, unions are not going to be any less political or costly. Whatever, physicians have got to stop making excuses and join together. First, they should join their state and county medical and speciality societies and then, get moving on further organizing-whether as a collective management company, union or merged group. The future will not be kind to the timid.

Payment Disclosures Under The Sunshine Law Is The Forecast Cloudy?, February 2012

by: Donald R. Moy, Esq.

DEA Administrative Inspections -Consent Or Not Consent?, January 2012

by: Robert J. Conroy, Esq. and Daniel G. Giaquinto, Esq.

Understanding IPAs, January 2012

by: Mathew J. Levy, Esq. and Stacey Lipitz Marder, Esq.

Understanding Physician Partnership/Shareholders'/Operating Agreements, January 2012

by: Mathew J. Levy, Esq. and Stacey Lipitz Marder, Esq.

Understanding Third Party Vendor Relationships, January 2012

by: Mathew J. Levy, Esq. and Stacey Lipitz Marder, Esq.

The Requirement of the On-call Physician to Come to the Emergency Department, January 2012

by: Michael J. Schoppmann, Esq. and Denise L. Sanders, Esq.

Wage Theft Prevention Act (WPT) - Reminder, January 2012

by: Donald R. Moy, Esq.

NY Supreme Court Upholds Authority of Comptroller to Audit Doctor, January 2012

by: Donald R. Moy, Esq.

Your Physician Assistant License At Risk; All Day, Every Day, January 2012

by: David L. Adelson, Esq. and Thomas M. Gallo, RPA, JD, Esq.

Are You Ready for the New ICD-10 and Electronic Version 5010? Changes Start Taking Effect in Early 2012..., December 2011

by: Robert J. Conroy, Esq. and Denise L. Sanders, Esq. and Matthew R. Streger, Esq.

When the FBI, OIG, IRS, OSHA (etc.) Knocks on Your Door, December 2011

by: Michael J. Schoppmann, Esq.

New Weapon to Combat False Claims Against New Jersey's Medicaid Program, October 2011

by: Daniel G. Giaquinto, Esq.

Understanding The Process of Merging Your Practice with A Large Mega Group or Hospital, October 2011

by: Mathew J. Levy, Esq. and Stacey Lipitz Marder, Esq.

White Paper - The Targeting of Physicians': Insights, Realities and Risk Management, July 2011

by: Michael J. Schoppmann, Esq.

Gotcha! When Malpractice Plaintiff's Fake or Exaggerate Injuries, July 2011, Contributor

by: Michael J. Schoppmann, Esq.

MSSNY Files Amicus Curiae Brief - NYS Comptroller Has No Authority to Audit Private Medical Practice, June 2011

by: Donald R. Moy, Esq.

Is the Routine Waiver of Patient Out-of-Pocket Costs Fraud?, June 2011

by: Donald R. Moy, Esq.

Physicians, Practices and Social Networks - Gauging the Risks, May 2011

by: Michael J. Schoppmann, Esq.

Dealing With Deceased Patients' Medical Records

by: Denise L. Sanders, Esq.

Defending Yourself Against Pain and Suffering Lawsuits, May 2011, Contributor

by: Michael J. Schoppmann, Esq.

Is A Compliance Plan Right For Your Practice?

by: Denise L. Sanders, Esq.

State Proposes Regulations to Implement the Registration of Surgical Practices

by: Denise L. Sanders, Esq. and Robert J. Conroy, Esq. and Charles H. Newman, Esq.

Licensure and Credentialing Consequences of a State Health Care Fraud Conviction in New Jersey, May 2011

by: Daniel G. Giaquinto, Esq. and Matthew R. Streger, Esq.

The Wage Theft Prevention Act - New Wage Notice Requirements for Employers, April 2011

by: Donald R. Moy, Esq.

How Reimbursements for Over-The Counter Medications Will Affect Physicians: (New Rules and Requirements), Spring 2011

by: Michael J. Schoppmann, Esq.

Accountable Care Organizations – “Facts and Fiction”, February 2011

by: Mathew J. Levy, Esq. and Michael J. Schoppmann, Esq. and Stacey Lipitz Marder, Esq.

Accountable Care Organizations - The FTC, CMS and OIG Perspective, February 2011

by: Donald R. Moy, Esq. and Michael J. Schoppmann, Esq. and Mathew J. Levy, Esq.

What is Clinical Integration and Why Is It So Important?, February 2011

by: Donald R. Moy, Esq. and Mathew J. Levy, Esq. and Michael J. Schoppmann, Esq.

CMS Final Rule – Written Disclosure Requirement for In-Office Ancillary Services Exception to the Prohibition on Physician Self Referral for MRI, CT and PET Services – Effective January 1, 2011, January 2011

by: Donald R. Moy, Esq. and Matthew T. Talty, Esq.

Understanding the Process of Starting a Medical Practice, January 2011

by: Mathew J. Levy, Esq. and Stacey Lipitz Marder, Esq.

Financial Arrangements Between Anesthesiologists, Ambulatory Surgical Centers and Gastroenterologists, January 2011

by: Mathew J. Levy, Esq. and Charles H. Newman, Esq.

What To Do When The Office Of Professional Discipline Gives You A Friendly Call, January 2011

by: Mathew J. Levy, Esq. and Lawrence F. Kobak, DPM, J.D., Esq.

FSAs, HSAs and Over-the-Counter Reimbursement: New Rules and New Requirements, January 2011

by: Michael J. Schoppmann, Esq.

FACING BILLING AUDITS: Don't get caught in the coming "tsunami" of reviews - be prepared instead, October 2010, Contributor

by: Michael J. Schoppmann, Esq.

How the Title of “Disruptive Physician” Can Ruin Your Career and How to Avoid It

by: Michael J. Schoppmann, Esq.

Appellate Division Upholds Right to Arbitrate Medical Malpractice Cases - But Only After Overcoming Huge Hurdle, August 2010

by: Steven I. Kern (1949-2011), Esq.

OPMC Consequences of Improper Delegation, August 2010

by: Michael J. Schoppmann, Esq.

Top Reasons Physicians Are Sued for Malpractice, August 2010

by: Michael J. Schoppmann, Esq.

More Stupid Regulations, July 2010

by: Steven I. Kern (1949-2011), Esq.

Physician Legal Alert: RAC Audits and How Physicians Should Prepare, June 2010

by: Michael J. Schoppmann, Esq. and Stacey Lipitz Marder, Esq.

An End to Class Action Abuse?, April 2010

by: Steven I. Kern (1949-2011), Esq.

Is it Time to Opt Out of Medicare?, April 2010

by: Steven I. Kern (1949-2011), Esq.

Ranking State Medical Boards, Are the Best Really the Worst?, April 2010

by: Steven I. Kern (1949-2011), Esq.

Understanding the Process of Selling a Medical Practice, April 2010

by: Mathew J. Levy, Esq. and David N. Vozza, Esq.

Understanding the Negotiation of Managed Health Care Contracts, April 2010

by: Mathew J. Levy, Esq. and David N. Vozza, Esq.

An End to Malpractice Trials, March 2010

by: Steven I. Kern (1949-2011), Esq.

Physicians as Targets: Insights, Hard Realities and How to Risk Manage Them, March 2010

by: Michael J. Schoppmann, Esq.

White Paper - Physicians' Rights Issues the Misreading and Misapplication of New York State Insurance law §3224-b by New York Health Plans, November 10, 2009

by: Michael J. Schoppmann, Esq. and David N. Vozza, Esq.

Abusing the False Label of “Disruptive” in Today’s Medicine, November 2009

by: Michael J. Schoppmann, Esq.

Physician Legal Alert: Risk Management One Day a Year, November 2009

by: Michael J. Schoppmann, Esq.

Who's Stealing From the Sample Closet?, October 2009, Contributor

by: Michael J. Schoppmann, Esq.

Supply - Demand and the A.M.A., September 2009

by: Steven I. Kern (1949-2011), Esq.

Continued Erosion of the Medical Profession: We Need to Stop the Bleeding, August 2009

by: Steven I. Kern (1949-2011), Esq.

Rationing Healthcare: Who Decides When to Pull the Plug on Grandma?, August 2009

by: Steven I. Kern (1949-2011), Esq.

The Heat's Getting Hotter: Healthcare Prosecutions to Rise Dramatically, August 2009

by: Steven I. Kern (1949-2011), Esq.

Is the New Joint Commission Mandate that Healthcare Institutions Address Disruptive Behaviors an Appropriate Standard?, May & June 2009, Contributor

by: Michael J. Schoppmann, Esq.

Red Flag Rules Redux, May 15, 2009

by: Steven I. Kern (1949-2011), Esq.

Hospital Responsible for Patient's Surgical Bill Where Doctor Doesn't Participate with Patient's Insurance Plan, April 20, 2009

by: Steven I. Kern (1949-2011), Esq.

Governor Corzine Signs Legislation Amending Facilities Licensing Law and Codey Law, April 2009

by: Robert J. Conroy, Esq. and Denise L. Sanders, Esq.

Electronic Health Records. Will it Reduce Malpractice Claims?, March 2, 2009

by: Steven I. Kern (1949-2011), Esq.

New "Red Flag Rules" Apply to Physician Practices, March 24, 2009

by: Steven I. Kern (1949-2011), Esq.

Exclusive Contracts Between Hospitals And Physicians Under Scrutiny After Decision By Federal Appeals Court, February 2009

by: Steven I. Kern (1949-2011), Esq.

No Class In Class Action Litigation, February 2009

by: Steven I. Kern (1949-2011), Esq.

I'm Not Sorry for Not Saying I'm Sorry, January 23, 2009

by: Steven I. Kern (1949-2011), Esq.

Physician Legal Alert: "New Red Flag Rules" & Physician Practices, Fall 2009

by: Michael J. Schoppmann, Esq.

Physician Legal Alert: Abuse, Abandonment, Cruelty and Neglect: Pediatrics Reporting Obligations in New Jersey, Winter 2009

by: Michael J. Schoppmann, Esq.

Whose Side Are They On?, December 16, 2008

by: Steven I. Kern (1949-2011), Esq.

Medical Board Attacked from Former Insider. November 18, 2008

by: Steven I. Kern (1949-2011), Esq.

Patient Testimonials - More Risk than Reward?, June 2008

by: Michael J. Schoppmann, Esq.

Physicians' Best Chance for Power, June 2008

by: Michael J. Schoppmann, Esq.

Another Blow to Ambulatory Care Centers, May 22, 2008

by: Steven I. Kern (1949-2011), Esq.

Fewer Stark Changes Than Expected - But Still Significant, February 22, 2008

by: Denise L. Sanders, Esq.

White Paper - Physicians' Rights Issues Under the Office of Professional Medical Conduct State of New York, January 18, 2008

by: Michael J. Schoppmann, Esq.

Beware of, and Be Ready for, The New Stronger, Office of Professional Medical Misconduct, Fall 2008

by: Michael J. Schoppmann, Esq.

Physician Legal Alert: The Coming Threat of RAC Audits and How to Avoid Them, Winter 2008

by: Michael J. Schoppmann, Esq.

The Hidden Threats, and New Realities of Medical Staff By Laws, Spring 2008

by: Michael J. Schoppmann, Esq.

Nurses in a Retail Setting: The Risks to a Supervising Physician, December 2007

by: Michael J. Schoppmann, Esq.

Appellate Division Upholds Gross Receipts Tax on Ambulatory Care Centers, November 2007

by: Steven I. Kern (1949-2011), Esq.

More Ways to be Sued-New Informed Consent Forms Required for Physician Protection, November 2007

by: Steven I. Kern (1949-2011), Esq.

Compliance Programs - A Preemptive Strike, November 2007

by: Daniel G. Giaquinto, Esq.

Understanding the Retail Based Clinic Debate, November 2007

by: Mathew J. Levy, Esq.

DOBI Adopts New PIP Medical Fee Schedule - Many Physicians Unhappy, September 2007

by: Denise L. Sanders, Esq.

Anti - Physician Acronyms, July - September 2007

by: Michael J. Schoppmann, Esq.

Understanding the Issues Related to Concierge Medicine, September 2007

by: Mathew J. Levy, Esq.

From PIP ARB to Penitentiary, August 2007

by: Steven I. Kern (1949-2011), Esq. and Daniel G. Giaquinto, Esq.

Dealing with the Long-Term Drug Dependent Patient, May 2007

by: Steven I. Kern (1949-2011), Esq.

Let’s Go To The Video Tape Board of Medical Examiners Eviscerates Chaperone Rule Protections, Responding to Patients Personal Crises May be Punishable Boundry Violation, May 2007

by: Steven I. Kern (1949-2011), Esq.

Yes, There is Justice!, April 2007

by: Steven I. Kern (1949-2011), Esq.

Federal Tools To Combat Health Care Fraud and Abuse, April 2007

by: Daniel G. Giaquinto, Esq.

How Physicians Won-Acting Together, and Without Litigation - A New Approach?, February 2007

by: Michael J. Schoppmann, Esq.

Expect More From Your Residents - A Court Will, January 2007

by: Steven I. Kern (1949-2011), Esq.

New Jersey Residents Held to Higher Standard of Care, January 2007

by: Steven I. Kern (1949-2011), Esq.

New York Enacts New Law Requring Accreditation of Office Based Surgical Practices, Fall 2007

by: Michael J. Schoppmann, Esq.

Retrospective Audits: How to Avoid Them, Winter 2007

by: Michael J. Schoppmann, Esq. and Mathew J. Levy, Esq.

Do We Need Specialized Courts?, November 20, 2006

by: Steven I. Kern (1949-2011), Esq.

The Criminalization of Medicine, November 13, 2006

by: Daniel G. Giaquinto, Esq.

Litigation of Hospital Medical Staff Matters, October 24, 2006

by: Robert J. Conroy, Esq.

A Step in the Right Direction for Managed Care Reform, But..., October 2006

by: Michael J. Schoppmann, Esq.

Office Based Surgery Audits - a.k.a. The Facility Fee Fight, September 2006

by: Michael J. Schoppmann, Esq. and Mathew J. Levy, Esq.

New Jersey Hospital Medical Staffs and Medical Staff Peer Review Litigation, August 2006

by: Steven I. Kern (1949-2011), Esq. and Robert J. Conroy, Esq.

Hidden Issues in the Need for Tort Reform, April & May 2006

by: Michael J. Schoppmann, Esq.

A Physician's Primer for the 2006 Office of Inspector General's Work Plan, Spring 2006

by: Michael J. Schoppmann, Esq.

How Physicians Can, and Must, Protect Themselves, Summer 2006

by: Michael J. Schoppmann, Esq.

Understanding Physician Employment Contracts, October 2005

by: Steven I. Kern (1949-2011), Esq. and Mathew J. Levy, Esq.

What If? Can your office make a comeback from disaster?, September 2005

by: Robert J. Conroy, Esq.

Understanding Partnerships Limited Liability Companies & Corporations, July/August 2005

by: Mathew J. Levy, Esq.

Risk Reduction Measures Against OPMC Actions, July 2005

by: Michael J. Schoppmann, Esq.

Overzealous Investigators Placing Physicians at Risk, February 2005

by: Michael J. Schoppmann, Esq.

Medicare Fraud Alert Misconceptions: The Path to Prison?, Fall 2005

by: Steven I. Kern (1949-2011), Esq. and Michael J. Schoppmann, Esq.

Risk Reduction Measures Against State Board Actions, Fall 2005

by: Michael J. Schoppmann, Esq.

Understanding Estate Planning and Wills, Spring 2005

by: Mathew J. Levy, Esq.

Physician Risk Management in Fraud and Abuse, December 2004

by: Michael J. Schoppmann, Esq.

HIPAA Compliance: The Law Reality, and Recommendations, October 2004

by: Michael J. Schoppmann, Esq. and Denise L. Sanders, Esq.

Physicians Win Lawsuit, September 2004

by: Mathew J. Levy, Esq.

Understanding Asset Protection and Family Limited Partnerships, September 2004

by: Mathew J. Levy, Esq.

Understanding Physician Lease Agreements & The Anti-Kickback Statue, May-June 2004

by: Mathew J. Levy, Esq.

An Introduction to the OIG's Compliance Guidelines, April 2004

by: Michael J. Schoppmann, Esq.

Physician Compliance with Government Investigations, January-February 2004

by: Michael J. Schoppmann, Esq.

Health Plans Versus Physicians: New Legal Threats, December 2003

by: Michael J. Schoppmann, Esq.

The Need for OPMC Reform, September 2003

by: Michael J. Schoppmann, Esq.

Appellate Court Offers Best Reason for Tort Reform, June 30, 2003

by: Steven I. Kern (1949-2011), Esq.

New Supreme Court Rulings and Their Impact on Your Practice, June 2003

by: Michael J. Schoppmann, Esq.

Tort Reform-Statistics, Solutions and Strategies, June 2003

by: Michael J. Schoppmann, Esq.

HHS Provides Further Modifications to HIPAA Privacy Rules as Deadlines Approach, September 2002

by: Michael J. Schoppmann, Esq.

The Office of Professional Medical Conduct, June 2002

by: Michael J. Schoppmann, Esq.

HIPAA Privacy Rules: The Future Impact for Physicians?, September 2001

by: Michael J. Schoppmann, Esq.

HIPAA Privacy Rules Imposed As Mandatory for all Physicians, Summer 2001

by: Michael J. Schoppmann, Esq.

Sexual and Other Harassment in The Operating Room Setting, Winter 2001

by: Michael J. Schoppmann, Esq.

Medicare Fraud Alert Top Ten Ways to Avoid a Medicare Fraud Investigation, June 2000

by: Michael J. Schoppmann, Esq.

Physician Unions - The Myths and a Potential Truth, Summer 1999

by: Michael J. Schoppmann, Esq.

Searching For New Criminals for the Millennium?, May 1998

by: Michael J. Schoppmann, Esq.

Dramatic Increase In Numbers Of Medicare Audits

by: Steven I. Kern (1949-2011), Esq.

First Warrantless Searches - Now Jail!

by: Steven I. Kern (1949-2011), Esq.

Flurry of Proposed Regulations and Legislation Likely to Create New Hardships for Physicians

by: Steven I. Kern (1949-2011), Esq.

Government Investigations - How Bad Things Can Happen to Good Doctors

by: Robert J. Conroy, Esq.

Horizon Class Action Settlement Challenged by State Physicians

by: Steven I. Kern (1949-2011), Esq.

How Well Does the Insurance Company's Lawyer Protect Your Rights?

by: Steven I. Kern (1949-2011), Esq. and Michael J. Schoppmann, Esq.

Managed Care Contracting Is Still A Dangerous Game

by: Michael J. Schoppmann, Esq.

Medical Board Issues New Rules For Administering, Dispensing and Prescribing Drugs

by: Steven I. Kern (1949-2011), Esq.

Medical Economics: How Much Insurance Do You Need?

by: Steven I. Kern (1949-2011), Esq.

National Practitioner Data Bank Changes Affect Podiatrists

by: Denise L. Sanders, Esq. and Matthew R. Streger, Esq.

OIG Compliance Program for Individual And Small-Group Physician Practices

by: Steven I. Kern (1949-2011), Esq. and Denise L. Sanders, Esq.

OIG Rules Hospitals Can Pay Physicians for On-Call Services – Pits Hospital Against Medical Staffs for Uncompensated Care Dollars

by: Steven I. Kern (1949-2011), Esq.

Organizing Physicians – Legal Issues

by: Steven I. Kern (1949-2011), Esq.

Physicians Unions – Barriers – Alternatives

by: Steven I. Kern (1949-2011), Esq. and Robert J. Conroy, Esq.

Physicians Unions - The Solution or Just Another Problem

by: Steven I. Kern (1949-2011), Esq. and Robert J. Conroy, Esq.

Proposed Board of Medical Examiners Rule Could Close Many Ambulatory Surgery Centers

by: Steven I. Kern (1949-2011), Esq. and Denise L. Sanders, Esq.

Relationship Between Board Of Medical Examiners And Organized Medicine At All Time Low

by: Steven I. Kern (1949-2011), Esq. and Denise L. Sanders, Esq.

The Princess or the Talking Frog

by: Steven I. Kern (1949-2011), Esq.

Universal Health Care In New Jersey – On The Horizon

by: Steven I. Kern (1949-2011), Esq.

What To Do When Your Partner Starts Acting Erratically?

by: Steven I. Kern (1949-2011), Esq.