You've got an endless stream of contracts from health plans and insurance companies. Do you know where the old ones are? Do you know if the "update" you are being asked to sign is actually decreasing your rate of reimbursement? Surely you don't have any leverage. Or do you?
How about those employment contracts you've had in place for years? Do they still reflect the responsibilities of your employees? Should some employees be independent contractors instead?
What about those documents forming your medical practice? The ones that are supposed to shield you from personal liability. Have you made sure to keep your corporation separate from your personal assets? Do you know what the managing partner of your limited partnership is supposed to be doing, and if there are consequences of failing to follow your founding documents?
No doctor went into medicine to practice business, and yet that is precisely what the law requires of you these days. Are you counting on a medical administrator to keep track of your legal obligations and assist you in making choices with legal ramifications?
Perhaps it's time for a legal check-up.
Take control of your practice.
A medical administrator tasked with legal or quasi-legal responsibility can be an unhappy employee as can an employee who cannot effectively manage the day-to-day operations of your practice. To make matters worse, consider whether you put your administrator in a difficult position: If he or she actually identifies a potential problem, will you be asking that administrator to solve the problem as well? How much time will that take?
Doctors do not habitually turn to lawyers for business advice, but it may be time for you to do so. Contracts should reflect the reality of your practice. From a revenue perspective, consider using the data for MACRA compliance to support claims for greater commercial reimbursement. Show your economic value with data. Increasingly, the practices that benefit will be those able to show that they distinguish themselves from their competitors.
Employment contracts govern your expenses. Are you getting the value from your employees you can, or should tasks be reassigned? People perform best at what they like to do. Is an employee seeking a raise that you cannot afford? Perhaps you can make that employee happy with additional time off. Regardless, an efficient office depends on clear expectations; use this opportunity to make sure you're all on the same page.
You may not have looked at your founding documents in years, but it's a good idea to do so. You may not remember the details well at this point, and if you are acting inconsistently with those documents, you may have changed the nature of your organization. There can be important consequences if this is the case.
If you are set up as a corporation but have not observed corporate formalities, your personal assets may be at risk. If you are paying a general partner to manage the limited partnership, does this still make sense? If you own property 50/50, perhaps now is the time to consider what will happen when one of you wants to sell or retire and the other doesn't. Planning now is more sensible — and cheaper — than leaving money on the table or fighting in the long run.
You spend hours keeping up to date on medical developments; how much time do you actually have left to consider the changing legal landscape? You are not alone here; most of your colleagues share these challenges. But while medicine is straightforward for doctors, legal advice is the daily work of lawyers. Just as the business demands of medicine have grown over the years, so has the professional population of attorneys who specialize in representing physicians, just like you.
Find one, and get a check-up.
David M. Rosenberg-Wohl is president of Hershenson Rosenberg-Wohl, A Professional Corporation. HRW specializes in representing physicians in all aspects of their business. Its attorneys have nearly 50 years of experience in matters of direct relevance to medical practice, principally (1) practice formation, partnership and employment relationships; (2) leases, billing and collection; (3) risk, liability and unfair competition; and (4) purchase and sale. David Rosenberg-Wohl is a graduate of Harvard University and Harvard Law School. Joseph Hershenson is a graduate of Harvard University and Stanford Law School. Both come from medical families.