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North Carolina Open Thread: The Corporate Practice of Medicine Doctrine [1]
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Date: 2023-01-01
WUSF Public Media, Bernard J. Wolfson - Kaiser Health News, 12/28/2022
Doctors, consumer advocates, and some lawmakers are looking forward to a California lawsuit against private equity-backed Envision Healthcare. The case is part of a multistate effort to enforce rules banning corporate ownership of physician practices.
A group of emergency physicians and consumer advocates in multiple states are pushing for stiffer enforcement of decades-old statutes that prohibit the ownership of medical practices by corporations not owned by licensed doctors.
Thirty-three states plus the District of Columbia have rules on their books against the so-called corporate practice of medicine. (Florida is not one of them.) But over the years, critics say, companies have successfully sidestepped bans on owning medical practices by buying or establishing local staffing groups that are nominally owned by doctors and restricting the physicians’ authority so they have no direct control.
These laws and regulations, which started appearing nearly a century ago, were meant to fight the commercialization of medicine, maintain the independence and authority of physicians, and prioritize the doctor-patient relationship over the interests of investors and shareholders.
Those campaigning for stiffer enforcement of the laws say that physician-staffing firms owned by private equity investors are the most egregious offenders. Private equity-backed staffing companies manage a quarter of the nation’s emergency rooms, according to a Raleigh, North Carolina-based doctor who runs a job site for ER physicians. The two largest are Nashville, Tennessee-based Envision Healthcare, owned by investment giant KKR & Co., and Knoxville, Tennessee-based TeamHealth, owned by Blackstone.
Just Care, Diane Archer, 3/30/2022
Gretchen Morgenson reports for NBC News.com on a medical director fired after exposing the risks of emergency treatment at his hospital in Kansas City. Inadequate staffing jeopardized patient safety. But, his private-equity employers, Kolberg Kravis (KKR) and, before that, Clayton, Dubilier & Rice, like other for-profit owners of medical groups, were focused on maximizing profits.
Today, four in ten emergency departments are controlled by for-profit entities, which are responsible for the staffing. KKR, which owns Envision Healthcare, and Blackstone, another private equity group, which owns TeamHealth, are two big companies in this space.
Private equity firms are generally in the business of buying up companies, finding ways to increase their profits, often through cutting costs, and selling them off a few years later at a profit. Because emergency departments are big profit centers, private equity firms are buying up control of these departments and have been charged with interfering in the practice of medicine to the detriment of patients.
Fortune, RAE ELLEN BICHELL AND KAISER HEALTH NEWS, 3/30/2022
Elizabeth Huffner thinks it is obvious: A full-term, healthy pregnancy results in a birth.
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