Why are you telling me I can't do what it is that
I want to do? This is a common question we hear in
relation to a lot of topics. But I'm going to dive
into just one right now, which is the corporate
practice of medicine. I'm Erin Jackson with
Jackson LLP Healthcare Lawyers. The corporate
practice of medicine, or CPOM, is a doctrine
that's enshrined in many states' laws, either by
statute, which is the laws on the books, or by
judge-made law--case law. So, what it means is
that only doctors can practice medicine. This has
come about out of concern that non-physicians
might exercise any sort of judgment or control
over a physician's independent medical judgment
for patient care. Thus, it prevents and prohibits
a business from practicing medicine. That is, I,
as an attorney who's not a doctor cannot hire a
doctor to work for our practice, to potentially
offer concierge medical care for our employees. A
therapist or a physical therapist also cannot hire
a doctor to work for their practice. This is
because the status of the doctor's employment with
that practice could interfere with the doctor's
independent medical judgment for patient care. So,
frequently, people reach out to us and say, "I
have a business that I would like to start. It's
going to offer this phenomenal level of care. I'm
not licensed in any way, but I wish to begin this
practice and to hire some doctors. My plan is to
pay the doctors each $100,000 a year and then I'm
going to bill the patients and I'll keep the money
from patient care. Win-win for everybody. Doctor
gets a steady salary and I am responsible for
collecting the billables and I get to keep them."
Well, if you're not licensed, so, if that was me,
or if that was a therapist or a nurse or a medical
assistant, that's not going to work because that
individual is being compensated based on the
volume and value of patients, and is potentially
going to impact the physician's independent
medical judgment. So, some people say, "Well, then
what?" Well, if you're really enthusiastic about
being involved in establishing and managing a
medical office, one option is to establish an MSO,
a management service organization, which allows
you to do things like manage their HR, not related
to physician hiring and such, but HR, marketing,
patient billing, although you can't keep the
money, real estate management, everything else
that goes into running a medical practice besides
rendering the actual medical care. So, if you run
an MSO, or one of these management companies, then
the next question is, "So, I can get a percentage
of what the doctor brings in each month, right?"
Again, we get back to the same problem with the
corporate practice of medicine. Someone who's not
a physician cannot receive money that comes
directly from patient care. So, if the money is
coming right out of the pot of money with
billables from patient care, that cannot go to
someone who's unlicensed. Instead, we typically
recommend setting a flat fee per month for the
management services. But this is a very
complicated issue that we've discussed in other
videos. So it's also important to remember
regarding the corporate practice of medicine, that
it applies to nonprofits. So it's not just about
whether there's money involved. It's truly about
whether someone other than a doctor's influencing
a doctor's medical judgment, this is a really
important issue, and it can have significant legal
consequences if it's not navigated correctly. If
you have any questions, feel free to reach out to
us. You can visit our website at JacksonLLP.com or
you can also schedule a consultation with one of
our attorneys.
