Face it: Marcus Welby you are not.  Today’s physicians face a number of challenges that make the practice of medicine nothing like it was in the old days.

In the brave new world of medicine, Shaw and Associates offers level-headed guidance, both when the path is smooth and when you hit some rough patches.  After handling more than 1,000 cases ranging from minor accidental injury to complex malpractice and product liability, Shaw and Associates has earned a reputation for aggressive litigation, tough negotiations, and early dismissals.  Our goal simply is to keep you and your practice out of harm’s way.  But when conflict is unavoidable, we’ll serve up strong medicine, in the maximum dose.

At Shaw and Associates, we’re specialists in providing medical professionals with full range of legal services.  With over 60 years of combined experience, we deliver the knowledgeable insights, personal support, and level-headed guidance you need in every facet of your life’s journey – - as a practitioner, a business owner, and a successful individual.

In case you missed it: the Obama Administration released its final rules on Accountable Care Organizations(ACOs) late last month as part of the implementation of health care reform.  The final rules reflected a number of changes recommended by physician organizations. Click here to learn more.

It’s official. Legal challenges to the controversial national health reform law will finally make their way to the highest court in the nation.

Last week, the U.S. Supreme Court announced that it will review several petitions arising from a Florida-based lawsuit brought by 26 states and the National Federation of Independent Business, now known as NFIB v. Sebelius.  The deliberations will take place in the spring with a decision expected by early summer 2012.

Though this lawsuit focuses primarily on the constitutionality of the “individual mandate” requiring nearly every American to purchase government-approved health insurance by 2014, a whole slew of other issues are already being felt by physicians and medical practices.

Among the concerns Shaw and Associates most often hears from our clients:

• HIPAA and electronic records requirements going into effect January 1st
• Anti-trust risks associated with “physician collaboration” required by healthcare reform law
• Regulatory compliance
• Practice management and business operations
• Medical Peer Review

What keeps you up at night? Perhaps we can help. Contact us for legal counsel or just general practice management advice.

The Patient Protection and Affordable Care Act and its rapidly-evolving regulations is creating an alarming amount of fear among physicians. Many are quickly deciding that their better option is to work underneath a corporate entity, hospital or Accountable Care Organization, rather than maintain their independent practices and face these landmark changes as medical specialists and business owners.

It’s understandable, given the challenges for physicians, both on the immediate and longer-term horizon.

Consider the looming challenge of managing ever changing regulatory and compliance measures, including:

• RAC Audits
• Medical Fraud Units
• False Claim Provisions
• Anti-Kickback
• Stark Regulations
• HIPPA Requirements
• OSHA Regulations
• Drug Regulations
• Licensing Requireents
• Criminal Prosecutions

Added to this growing regulatory pressure is another dark specter: declining reimbursements for physician services. The PPACA and Reconciliation Act indicates that direct Medicare spending will decline approximately $390 billion from FY 2010 to FY 2019. Moreover, health care economists predict that the private insurance plans will be forced to slash reimbursements in order to remain competitive in a marketplace of shrinking coverage options. Combine these trends with the dramatic Medicaid cuts coming down the pike, and the future can seem pretty dark and scary.

Given the fear of being responsible for compliance and not making enough to hire more staff to manage the paperwork, it’s no wonder physicians are choosing – in droves – to surrender their role as practice managers and business owners to let someone else worry about the regulatory headaches.

Although many of these concerns won’t actually apply to the average medical practice, many physicians have begun seeking to shield themselves beneath the armor of a corporate entity or ACO. They figure it will offer both the solution to their management needs and reduced individual liability. Further, the ACO promise of solid reimbursement gives a much-needed financial incentive.

Or so it seems. Even in the wake of health reform and the challenges it may pose, there are factors that make it worthwhile to fight the good fight to stay independent. And even the corporate saviors may be a bit too good to be true, given what could be a severe reduction in individual control over practice and management procedures, as well as overall influence.

Before making the switch from owner to employee, give significant consideration to what these reductions might mean and how they may affect you financially, professionally, and even in terms of personal fulfillment.

1) Financial Considerations — How is their billing set up? Does their billing cost exceed yours, and if so, will it minimize your returns? Will the compliance expenses, risk management expenses, benefit expenses or overhead expenses affect your returns?

2) Management Considerations — Will you have control over your contracts? Will you have the ability to choose and control your professional liability insurance company?

3) Personal Considerations — Will you be allowed to retain your same freedoms, flexibility and hours?

4) Ethical Considerations — Will you be forced to relinquish your power to decide whether or not to settle or try a case?

If you boldly choose to stay the course and steer your own ship, equal precaution is encouraged. Even as physicians who choose to affiliate with an ACO or corporate entity must consider reductions in their independence, those who opt to remain independent must prepare to bolster their internal business structures with qualified and efficient support for billing, regulatory compliance and financial management to make headway in the face of continued reimbursement reductions. These physicians should also be involved with their professional organizations to leverage strategic alignments with physician groups and other like-minded practice managers.

When it comes to making a decision about how to practice medicine, the choice is up to each physician. But for those resisting that urge to flock to ACOs, there will be much to learn. With so much in flux, now is the time to take the first step. Begin reaching out to professional organizations, like-minded physicians and supporting legal advisors to start you on our way.

If you’d like more information send an email to Diane Shaw for some initial consultation.

Check back soon to read some great posts!