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| Accommodating disabled patients
| The second-floor office where I'd like to set up my internal medicine practice is not accessible to patients in wheelchairs. However, if I need to see any wheelchair-bound patients, another physician in the building has offered to let me use his office downstairs. Would this arrangement satisfy ADA regulations? Also, what changes will I have to make to the restrooms to accommodate handicapped patients? | | | When a deaf patient demands an interpreter
| | One of my deaf patients is capable of communicating with me in writing or by typing on a computer. However, she insists on having a sign-language interpreter present when she comes to the office. Does the Americans with Disabilities Act oblige me to provide one? | | | Can you fire a staffer on disability leave?
| | My office manager has been on disability for three months. During that time, my other four employees have taken over her tasks, and we're doing quite well without her. Can I eliminate her position? | |  MORE ARTICLES
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| When a medical group practice partner retires
| | A senior partner has announced his plan to retire from our single-specialty group practice. We have a buy-out in place and expect his departure will be amicable. However, we have no experience with managing the details of a doctor's departure. For example, when should he tell his patients and referring doctors that he's leaving? What else do we need to do? | | | A mediator or an attorney?
| | Both my partner-to-be and I agree that the buy-in agreement we signed years ago needs to be renegotiated. But we disagree on some issues. Should we hire a mediator to help us hammer out a new contract, or should we each hire our own attorney? | | | Nailing down the terms of a practice sale
| | I plan to recruit an associate who would buy my practice when I retire in a few years. I'd like to start cutting back my work schedule as soon as he's comfortable. When we draft the buy-sell agreement, what provisions should I include to protect my interests? | | | What happens if a partner dies
| | I'm forming a practice with two other doctors. If one of us dies, does his ownership interest pass to his estate? Should the remaining partners be required to buy his share? What should our contract say about transferring ownership in the event of death? | | | Could a contract clause spoil your retirement plan
| | My younger associate, whom I assumed would succeed me, told me that he intends to resign. He says our buy-sell agreement obligates me to purchase his shares. I plan to retire next year, and this will upset my plans. What should I do? | | | Time to rethink this buy-out agreement
| | According to our small group practice's buy-sell agreement, part of the payout upon termination is return of capital invested. How does the practice provide for the payout without hurting the remaining doctors? | | | Can out-of-state docs bankroll your practice?
| | I want to start my own practice, but I can't get a loan from the bank because I have so much debt already. I have several private investors lined up, though--physicians licensed in another state--who would like to be shareholders in the professional corporation I'd set up. Is this legal? | | | MORE ARTICLES
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| Charging no-shows a fee
| | I just read the article on no-shows by Dr. Eric Shore (June 6, 2008 issue). I share his concern regarding physicians’ liability when patients neither arrive for their appointment nor cancel. There is an added expense for physicians to follow up on these unreliable patients. What are the legalities of charging no-shows a fee, and what is Medicare’s stance on this? | | | Debt collection
| | Is it okay to set up an in-office collection process for past due patient balances using a form letter that looks similar to a collection agencies letter? I have seen other office send these out. The letter usually has a letterhead that indicates something like "The Collection Center," and goes on to advise the patients that they have X number of days to pay their balance or further collection measures will be taken. | | | S corp, C corp, LLC, LLP—which is best?
| | Whether you're setting up a new practice or re-evaluating an existing one, here's help in sorting through your options. | | | MORE ARTICLES
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| Doctors' Legal Forum
| | Your source for up-to-date medical-legal news, risk self-assessment tools, directories of state laws and regulations, medical-legal glossaries, personal narratives, and Q&As on malpractice, business, and employment law, HIPAA, Stark rules, ADA mandates, and other information that today's physicians need to know. | | | MORE ARTICLES
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| Look out for employment contract snags
| | Be careful, because the terms of this agreement can have a profound impact on your career. | | | When a noncompete isn't ironclad
| | They're tough to break, but two Indiana doctors showed one way to do it. There are other ways that could work, too. | | | The end of restrictive covenants?
| | A state supreme court rules that "noncompete" clauses violate public policy by limiting patient access to medical care. | | | No contract? No good!
| | Leaving things to chance can spell disaster for your practice, the author says. | | | When a salary guarantee expires
| | This "base compensation" model provides built-in incentives for new physicians, and protects the group if they don't produce. | | Finding a Job
Step 4: Weighing offers
| | Before you sign an employment agreement, do your homework, talk with your advisers, then decide which offer you can't refuse. | | | A win-win alternative to noncompete clauses
| | For both groups and their employed doctors, there's now a fair and legal alternative to restrictive covenants. | | | 8 ways to escape your employer
| | Unhappy--and feeling fenced in by a noncompete clause? Chances are you can break free, with little or no penalty | | | Handshake partnerships: Tick...tick...tick...
| | This practice probably couldn&t have been saved, but the breakup could have been far less acrimonious. | | | MORE ARTICLES
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| E-prescribing: Follow the money—and former government officials
| | Remember internist David Brailer, once the point man for EHRs in the Bush administration? He’s now the chairman of a private-equity firm that’s bankrolling a healthcare IT startup with its own cast of ex-public servants. | | | E-prescribing: Big business, labor, insurers lobby for mandatory e-prescribing bill
| | A bill in Congress that would require doctors to e-prescribe for Medicare patients or else take a pay cut has been endorsed by an impressive list of groups representing patients, employers, and insurers. But only one major physician organization has jumped on the bandwagon. | | | E-prescribing: Pharmacies use patients to persuade doctors to throw away Rx pads
| | Maybe you’ve seen the signs at your local pharmacy saying “E-prescriptions filled here” and “Give your prescription a head start” They’re part of a campaign to encourage patients to convert their doctors to electronic prescribing. | | | E-prescribing: Going electronic just got a little easier
| | The push for e-prescribing is heating up, with bills in the House and Senate that would penalize providers who don't abandon paper scripts for Medicare patients by 2011. | | | E-prescribing: This website can help you pitch your Rx pad
| | You're under growing pressure to e-prescribe, but how do you get started? An interactive website co-sponsored by organized medicine walks you through the steps. | |
| The best programs for your handheld
| | When you practice medicine in the palm of your hand, you'll want a smartphone and cutting-edge programs. Here are the best. | | | Computerized Physician Order Entry: A Massachusetts insurer pressures hospitals to drop paper prescriptions
| | Starting in 2012, doctors in Massachusetts hospitals must order medications, tests, and procedures using computerized physician order entry (CPOE) if those hospitals want to earn quality-of-care bonuses from Blue Cross Blue Shield of Massachusetts. | | | Bill requires e-prescribing for Medicare, pay cuts for non-compliance
| | Identical Senate and House bills introduced last month would require you to electronically transmit prescriptions for Medicare patients to the pharmacy starting in 2011 or else take a pay cut. | | | Technology: The natives are getting restless
| | Last month, Partners Health Care in Boston announced it would require its network physicians to get electronic health records. Now the government has set the gears in motion to mandate e-prescribing. | | | MORE ARTICLES
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| Keys to a successful EHR rollout
| | From timetables to training, implementing a new system is more about people than computers. | | | EHRs: Use of full-fledged, "federally correct" systems is woefully low
| | Only four percent of physicians use a fully functional EHR that satisfies federally promoted certification requirements, while another 14 percent have basic systems. | | | EHRs: Mock vendor websites illustrate why some doctors distrust EHRs
| | If you want to better understand why less than 20 percent of doctors have implemented EHRs, visit the website of a vendor called Extormity, dedicated to offering "highly proprietary, difficult to customize and prohibitively expensive" software. | | | Personal Health Record: With Kaiser deal, Microsoft keeps pace with Google
| | The Google PHR that debuted in May connects to an impressive list of healthcare organizations. But the rival PHR from Microsoft has landed a big fish called Kaiser Permanente. | | | EHRs: Someday you won't call them EMRs
| | Baffled by look-alike terms such as electronic health record, electronic medical record, and personal health record? A $500,000 federal study tries to clear things up. | | | Drug Safety: FDA will monitor Medicare claims data for drug problems
| | Here's one more reason why the feds are pushing for a nationwide health information network--the ability to scour millions of electronic records and catch unexpected drug side effects as soon as possible. | | | EHRs: Consider these programs if you're strapped for cash
| | A new study from the AC Group identifies seven EHR vendors that give you the most digital bang for your buck. | | | Charting by computer without an EHR
| | Until I get an EHR, I've been typing my care notes into a Microsoft Word template. Then I print them out, sign them, and store them in the patient's chart. I save the electronic copy in read-only format on a network server that's password protected. Do you see any weaknesses in this system that, in a malpractice trial, might give a plaintiffs' attorney the opportunity to suggest that I could have altered records? | |
| EHRs: Governors' group recommends incentives--and mandates--for EHR use
| | First, give physicians incentives to adopt EHRs. Then make their use compulsory. It's a game plan from an offshoot of the National Governors Association for promoting digital medicine on a state level. | | | MORE ARTICLES
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