Physician Contracting 101 - this seminar will provide physicians with a baseline concept of the anatomy of a physician contract. Basics of negotiation and contracting for the physician professional are discussed herein
Decosimo's Shannon Farr and Anderson Busby's Amanda Busby co-presented this PowerPoint at the 2012 Tennessee Bar Association's Health Law Primer on October 3, 2012 in Brentwood, TN.
Small business healthcare reform questions taken and answers given during a recent Healthcare reform webinar hosted by Ohio CPA firm - Rea & Associates -
Employee Leave Issues: 5 Tips to Navigate the Bermuda Triangle of Employee Le...Sage HRMS
If your company has more than 50 employees within a 75-mile radius, it must follow the requirements of the Family and Medical Leave Act (FMLA). There are also additional federal and state laws that your company must abide by in order to remain compliant with leave entitlement programs. These laws include the American with Disabilities Act Amendments Act (ADA-AA), workers’ compensation laws, Uniformed Services Employment and Reemployment Rights Act (USERRA), and state leave laws.
It is imperative that employers stay up to date on changing compliance requirements in order to ensure that employees receive the benefits and protections of these laws, as well as to control costs, and avoid possible penalties.
Three of these laws, FMLA, ADA-AA, and workers compensation, often intersect and can be tricky for employers to follow. These laws are sometimes referred to as a “Bermuda Triangle” of employee leave. Decisions about employee leave, as well as tracking of leave and documentation must be handled properly, or your company could face lost productivity and compensatory or punitive damages.
Providing answers to healthcare reform questions including small employers, employee calculations, Penalty 4980H9, Affordability and other issues related to the pay or play provision of the healthcare reform - Obamacare.
Decosimo's Shannon Farr and Anderson Busby's Amanda Busby co-presented this PowerPoint at the 2012 Tennessee Bar Association's Health Law Primer on October 3, 2012 in Brentwood, TN.
Small business healthcare reform questions taken and answers given during a recent Healthcare reform webinar hosted by Ohio CPA firm - Rea & Associates -
Employee Leave Issues: 5 Tips to Navigate the Bermuda Triangle of Employee Le...Sage HRMS
If your company has more than 50 employees within a 75-mile radius, it must follow the requirements of the Family and Medical Leave Act (FMLA). There are also additional federal and state laws that your company must abide by in order to remain compliant with leave entitlement programs. These laws include the American with Disabilities Act Amendments Act (ADA-AA), workers’ compensation laws, Uniformed Services Employment and Reemployment Rights Act (USERRA), and state leave laws.
It is imperative that employers stay up to date on changing compliance requirements in order to ensure that employees receive the benefits and protections of these laws, as well as to control costs, and avoid possible penalties.
Three of these laws, FMLA, ADA-AA, and workers compensation, often intersect and can be tricky for employers to follow. These laws are sometimes referred to as a “Bermuda Triangle” of employee leave. Decisions about employee leave, as well as tracking of leave and documentation must be handled properly, or your company could face lost productivity and compensatory or punitive damages.
Providing answers to healthcare reform questions including small employers, employee calculations, Penalty 4980H9, Affordability and other issues related to the pay or play provision of the healthcare reform - Obamacare.
Review this presentation to understand how health insurance actually works and then visit us online at www.selectmycoverage.com to obtain a quote and apply
An open enrollment checklist, created by eHealthInsurance, to help employees find the best personal health insurance solution for the 2012 benefit year - via http://www.eHealthInsurance.com
In this straightened economic climate, redundancy is a threat faced by millions of UK employees. Large corporations are hitting the headlines by making thousands of their employees redundant, but redundancy could happen at a company of any size when things get tough and businesses are forced to cut their costs.
If you are an employee who is potentially facing redundancy, it is important to know your rights. If you are dismissed unfairly, you can take your employer to an employment tribunal and potentially claim a substantial payment, or even win your job back. And even if your dismissal is inevitable, it is critical that you fully understand the redundancy procedure and what alternatives may be available to you.
First, consult with your company's redundancy policy - this should outline the company's redundancy procedure and your rights as an employee. Here are a few of the areas that should be covered...
What are Acceptable and Unacceptable Reasons for Redundancy?
If an employer wants to make one or more members of their company redundant, the reasons given must be legally acceptable. Essentially, your job must disappear, either because the company is ceasing operation or the position is no longer necessary (the business is reducing its operations, closing a particular branch, technology has rendered the job obsolete, and so on.)
When it comes to selecting individual employees for redundancy there are certain criteria that are permissible for selecting one employee rather than another:
? Attendance and Disciplinary Record - Redundancies based on attendance and discipline must be backed up with documentation (written warnings, records of attendance and so on)
? Standard of Work - This also needs to be backed up with objective written evidence (typically from employee appraisals)
? Skills and Qualifications - Employees can be selected for redundancy if they have comparatively weaker skills and qualifications than their fellow workers
If the reason given for your redundancy is not one of these, you may have a case for unlawful dismissal. Moreover, the following are some of the reasons that are automatically considered to be unfair dismissals:
Being made redundant due to trade union membership or non membership
Redundancies associated with pregnancy or maternity/paternity/adoption leave
Any redundancy due to discrimination (gender, orientation, religion, age, and so on)
What are the Alternatives?
If you have a meeting concerning possible redundancy with your employer, it is wise to discuss the potential alternatives. These may include the elimination of overtime, shifting to part time work, a job share scheme, and other similar schemes. Your company redundancy policy may detail acceptable alternatives, and note that you also have the right to appeal a redundancy decision.
More info : - http://www.newcitycompare.co.uk
Health Care Reform Strategies for Small Employers:
• Health Care Tax Credits and Penalties
• The Recently Delayed Pay or Play Mandate
• Health Insurance Exchanges
• SHOPs
• Other Cost-Savings Opportunities
• Strategic Decision Making for Large and Small Employers
• And more!
Every American is entitled and bound to avail Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA) - also known as Obamacare. While some opt for individual health insurance plans offered by private institutions, more than 60% opt for Employer-Sponsored Health Insurance. Employer-Sponsored Health Insurance makes your work easy because you don't have to go through multiple insurance plans available online. Employers, on an average pay 82% of your premium for a single insurance policy. For employers also this is a win-win situation because it results in employee retention, better health of employees thus more productivity. Employers use good health benefits as a great tool to recruit sought-after talent in the industry.
The slide deck talks about Employer-Sponsored Health Insurance, its comparison to individual health insurance and the win-win situation for employee and employer.
Navigating Health Insurance in the Health Care Reform Era lkennon
A presentation for large employers, small employers and individuals without employer-based insurance. The slides present the current state of health insurance for each group and the impending changes of Health Care Reform and their potential effects.
FAIR MARKET VALUE & COMMERCIAL REASONABLENESSCBIZ, Inc.
FAIR MARKET VALUE AND COMMERCIAL REASONABLENESS:
What we have learned in the last decade from our role as Governments Consulting Experts and involvement in Hospital Transactions.
Review this presentation to understand how health insurance actually works and then visit us online at www.selectmycoverage.com to obtain a quote and apply
An open enrollment checklist, created by eHealthInsurance, to help employees find the best personal health insurance solution for the 2012 benefit year - via http://www.eHealthInsurance.com
In this straightened economic climate, redundancy is a threat faced by millions of UK employees. Large corporations are hitting the headlines by making thousands of their employees redundant, but redundancy could happen at a company of any size when things get tough and businesses are forced to cut their costs.
If you are an employee who is potentially facing redundancy, it is important to know your rights. If you are dismissed unfairly, you can take your employer to an employment tribunal and potentially claim a substantial payment, or even win your job back. And even if your dismissal is inevitable, it is critical that you fully understand the redundancy procedure and what alternatives may be available to you.
First, consult with your company's redundancy policy - this should outline the company's redundancy procedure and your rights as an employee. Here are a few of the areas that should be covered...
What are Acceptable and Unacceptable Reasons for Redundancy?
If an employer wants to make one or more members of their company redundant, the reasons given must be legally acceptable. Essentially, your job must disappear, either because the company is ceasing operation or the position is no longer necessary (the business is reducing its operations, closing a particular branch, technology has rendered the job obsolete, and so on.)
When it comes to selecting individual employees for redundancy there are certain criteria that are permissible for selecting one employee rather than another:
? Attendance and Disciplinary Record - Redundancies based on attendance and discipline must be backed up with documentation (written warnings, records of attendance and so on)
? Standard of Work - This also needs to be backed up with objective written evidence (typically from employee appraisals)
? Skills and Qualifications - Employees can be selected for redundancy if they have comparatively weaker skills and qualifications than their fellow workers
If the reason given for your redundancy is not one of these, you may have a case for unlawful dismissal. Moreover, the following are some of the reasons that are automatically considered to be unfair dismissals:
Being made redundant due to trade union membership or non membership
Redundancies associated with pregnancy or maternity/paternity/adoption leave
Any redundancy due to discrimination (gender, orientation, religion, age, and so on)
What are the Alternatives?
If you have a meeting concerning possible redundancy with your employer, it is wise to discuss the potential alternatives. These may include the elimination of overtime, shifting to part time work, a job share scheme, and other similar schemes. Your company redundancy policy may detail acceptable alternatives, and note that you also have the right to appeal a redundancy decision.
More info : - http://www.newcitycompare.co.uk
Health Care Reform Strategies for Small Employers:
• Health Care Tax Credits and Penalties
• The Recently Delayed Pay or Play Mandate
• Health Insurance Exchanges
• SHOPs
• Other Cost-Savings Opportunities
• Strategic Decision Making for Large and Small Employers
• And more!
Every American is entitled and bound to avail Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA) - also known as Obamacare. While some opt for individual health insurance plans offered by private institutions, more than 60% opt for Employer-Sponsored Health Insurance. Employer-Sponsored Health Insurance makes your work easy because you don't have to go through multiple insurance plans available online. Employers, on an average pay 82% of your premium for a single insurance policy. For employers also this is a win-win situation because it results in employee retention, better health of employees thus more productivity. Employers use good health benefits as a great tool to recruit sought-after talent in the industry.
The slide deck talks about Employer-Sponsored Health Insurance, its comparison to individual health insurance and the win-win situation for employee and employer.
Navigating Health Insurance in the Health Care Reform Era lkennon
A presentation for large employers, small employers and individuals without employer-based insurance. The slides present the current state of health insurance for each group and the impending changes of Health Care Reform and their potential effects.
FAIR MARKET VALUE & COMMERCIAL REASONABLENESSCBIZ, Inc.
FAIR MARKET VALUE AND COMMERCIAL REASONABLENESS:
What we have learned in the last decade from our role as Governments Consulting Experts and involvement in Hospital Transactions.
The Ultimate Guide to Choosing the Right Medical Billing Agency.pdfmedquikhelathsolutio
In the ever-complex healthcare landscape, navigating the world of medical billing can be a daunting task. Reimbursement rates are constantly changing, insurance regulations are intricate, and ensuring accurate claim submissions is paramount for financial stability.
Navigating Relationships Between Hospital and Physicians--Negotiating and Val...PYA, P.C.
Offering a broad understanding of laws and regulations in the healthcare industry, this presentation serves as a valuable training program for new associates and in-house counsel, and an excellent refresher for experienced health lawyers as well.
Here are 7 Health Insurance Questions, Answered: 1. What Is Health Insurance? 2. Why Do I Need Health Insurance? 3. What Are the Different Types of Health Insurance? 4. What Is a Premium, Deductible, and Copayment?
Chapter 6Alternative Responses and Initiatives of Institutions aJinElias52
Chapter 6
Alternative Responses and Initiatives of Institutions and Professions
Nongovernmental health care organizations provide most medical services and handle the financing of much of the system. For-profit and nonprofit institutions operate side by side, often competing directly for the same business.
This chapter identifies a number of strategies that individuals and organizations adopt in response to governmental programs or initiate on their own to influence health policy. We start with Table 6-1, which outlines the actors and the alternatives for responding to government actions and the marketplace. Where alternatives have been addressed and terms defined in earlier chapters, we try not to repeat that information.
6.1 COMMON RESPONSES
All of the players listed in Table 6-1 employ strategies to influence the marketplace and its regulators. These can be classified into three main types of interventions:
• Public relations
• Marketing and education
• Lobbying
Table 6-1 Responses and Initiatives of Institutions and Professions
Common Approaches
• Public relations
• Marketing and education
• Lobbying
Payers
• Employers
• Eligibility
• Subsidy offered
• Plans offered
• Relationship with insurers/self-insurance
• Worker education and training
• Insurers
• Method of organization
• Method of payment
• Plans offered
• Case management/carve-outs
• Utilization constraints
• Consumer education
Providers
• Professionals
• Organization of practice
• Services offered
• Incentives
• Pricing
• Patient relationships
• Primary versus specialty care
• Efficiency
• Institutions
• Organizational structure
• Scope and scale of services
• Pricing/discounts
• Efficiency
• Quality improvement
• Consumer information
• Credentialing decisions
• Involving payers in change processes
• Professions
• Quality improvement
• Provider education
• Consumer education
Consumers
• Plan selection
• Provider selection
• Self-help
Each player manages its relationships with the media and with politicians and regulators directly, and each acts indirectly through trade associations and professional groups. You will see illustrations of this throughout the cases included in this text and in subsequent chapters dealing with political feasibility and values. The focus of each intervention changes depending on the nature of the specific market. Lobbying is particularly intense in administered markets such as Medicare and Medicaid, especially when new legislation is under consideration. Lobbying also goes on continuously with the relevant executive branch agencies. Public relations and education are used more assertively when regulators are considering changes, and marketing, especially advertising, is most intense where the market is less regulated. The term education can apply to the many different types of efforts to influence behavior. Government antismoking campaigns can be characterized as education, for example, but the term can also ...
Do you want to know what healthcare contract management is? Let’s read this article & learn about the healthcare contract and policy management processes.
Louisiana Medical Malpractice Basics - how to navigate the Louisiana Medical Malpractice Act when dealing with defending hospitals and physicians. This presentation will provide information on statutes, medical review panel process, defense strategies on defending physicians/hospitals from medical malpractices
Meyer staying connected when is mobile technology harmful to patients fina...Conrad Meyer JD MHA FACHE
Staying connected when is mobile technology harmful to patients: Physicians and nurses are constantly interrupted and distracted during delivery of healthcare to patients. Since healthcare is data driven, Physicians and nurses are using smartphones, tablets, iPhones, iPads and other devices to constantly stay connected to the latest data. In addition, studies show that society as a whole, including Physicians and nurses, feel a constant desire to "stay connected" to the internet and social media. So when does all of this connectivity harm patients? When Physicians and nurses are distracted and lose focus from tending to their patients, bad things can happen - missteps, missed medications, over medications, wrong side surgeries, etc. just to name a few. When patients are paying for a Physician's or a nurse's focus - patients should expect to receive it. The challenge for Hospitals, Physicians and nurses in this age of "staying connected" is how to manage all of the distractions, whether or not causes by smartphones or tablets, and to provide the focus of their attention on those who not only paid for it, but expect it to make sure they receive the healthcare they need: the patients. This presentation provides some insights on what other studies have found and some suggestions on what policies might help in managing the distractions/interruptions healthcare providers face in the ever growing digital age!
Physician Integration - Seeking provider based status and how to navigate its' compliance. Evaluation of provider based status for physician integration.
Louisiana medical psychologists telemedicine overview - the who, what, when, ...Conrad Meyer JD MHA FACHE
Louisiana Telemedicine Telehealth Law - Who, what, when, where and how. Everything you need to know about the current state of affairs with respect to Telemedicine and its application to Louisiana Regulatory Scheme. If you are a physician looking to setup a telemedicine practice in Louisiana or a Louisiana Physician or medical psychologist looking to expand your practice with telemedicine, this presentation can help you.
psychiatry and mental health issues in the emergency room - EMTALA and State ...Conrad Meyer JD MHA FACHE
Dealing with Psychiatric and Mental Health Patients can be a challenge for a hospital from a compliance standpoint. What should hospitals know about EMTALA compliance and Louisiana State Law compliance when dealing with mental health or pschy patients? Read to find out.
Tulane Medical School - med/peds resident presentation medical malpractice av...Conrad Meyer JD MHA FACHE
Tulane Medical School - Presentation to Med/Peds Residents on Medical Malpractice Avoidance, documentation, communication with patients and staff. Discussion included series on "distracted physicians" and use of smart devices that distract from patient care.
The focus on communication with patients along with proper history from patients and family was a key factor in decreasing medical malpractice suits. In addition, the expression of compassion or empathy when adverse outcomes arise plays a key role in decreasing medical malpractice suits. This followed a review of the Louisiana "I'm Sorry" law and its application
Analysis of the CMS 60-day rule in light of Healthfirst Case and Self Disclos...Conrad Meyer JD MHA FACHE
This presentation is an analysis of the CMS 60-day rule regarding overpayments received by a healthcare provider from Medicare or another federal healthcare program. It looks into the first case where the DOJ has intervened in a False Claims Act (FCA) case involving the 60-day rule application - the Healthfirst case out of NY. This case will be the first time the Court is going to address the issue of when an overpayment is "identified" pursuant to the rule. In addition, the presentation discusses the issue of what happens when a healthcare provider does "identify" an overpayment and whether or not the healthcare provider should engage in the Self Disclosure Protocol (SDP) and the steps a healthcare provider should look to when considering the SDP.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
1. LSU School of Medicine-New Orleans (LSUSOM-NO) is the
provider of Continuing Medical Education for this activity.
The planning and presentation of all LSUSOM-NO
activities ensure balance, independence, objectivity and
scientific rigor.
1
The LSU School of Medicine-New Orleans
designates this educational activity for a
maximum of 1 AMA PRA Category 1
Credit(s) ™. Physicians should claim only the
credit commensurate with the extent of
their participation in the activity.
2. Disclosure
2
I do not have the following
relationship(s) with commercial interests.
A commercial interest is any entity
producing, marketing, re-selling, or
distributing health care goods or services
consumed by, or used on, patients.
3. Contracting 101
The good, the bad, and the ugly!
Conrad Meyer Esq., MHA FACHE
Sarah J. L. Christakis, Esq., J.D., L.L.M.
Chehardy Sherman, LLP
cm@chehardy.com
sjlc@chehardy.com
(504) 833-5600
3
4. why is it important you have a health care
lawyer?
You have spent 4 years of high school, 4 years of college, 4 years of medical school,
and 4-6 years as a resident – Now you are ready to begin your career!
You search for a practice or hospital employment
You met the partners or the administrator
You are a hit
They offer you a position
Hand you a contract
You like the compensation
You reach for your pen – STOP!
What are the other terms in the contract?
Duties? Scope? Termination Provisions? Partnership? Compensation structure?
Must read cover to cover – consider it a rough draft!
Terms are negotiable! Both sides will compromise….
4
5. Preliminary Issues
Contracts for employers are drawn up by attorneys
Usually drafted to favor employers
Usually two different types
Straight Employment
Recruitment Agreement
Your lawyer is there to help you:
Assist you with malpractice coverage and/or liability issues:
Tail coverage
Time period for coverage
Indemnity – who indemnifies
Notice issues
Termination
With and without cause
Ownership of Patients lists/Medicare Records
Notice to patients if Practice closes – avoidance of LSBME problems
5
7. Marriage?
Employment – akin to marriage
Know your partner
Groups goodwill in the healthcare community
Qualities should include:
Honesty, integrity, free and open communication, mutual respect, and
trust
Ask to see the books –
Understand Practice Finances
Know your overhead – production bonuses
Partnership provisions:
Buy in
Buy out
7
9. Devil is in the details!
Physicians fail to get everything on paper:
Must get every aspect of employment agreement in writing
Expectations
production
Obligations
Call schedule
Compliance with third party payors
Compliance with accounting/bookkeeping
Oral promises get lost/forgotten
Contract should be detailed with little room for interpretation
9
10. Negotiations
Before negotiations determine:
Salary desires
Benefits
Working conditions
Look for deal breakers – prioritize deal breakers
Partnership track – timeline/productivity/buy in
Can you accept these terms?
Long office/on-call hours/schedule
Be realistic:
Employers want to stick to their standard contract
Major concessions can cause disputes
You will not get everything you want
10
12. Devil is in the details!
Pay Attention to the Definitions
Contracts should cover:
Office hours, time on call, MCLE reimbursement, professional dues, and
vacation time
Focus items:
Compensation and benefits
New hires – usually fixed salary for a year (minimum)
Salary – MGMA guidelines
If based on productivity – RVU based, Quality based, Production based
Call schedule
If contract renews automatically make sure to address salary increase
Moving expenses – covered?
Benefits should be clear! – Health, life and disability insurance –
pension/retirement provisions (vesting and eligibility)
12
13. Devil is in the details!
Term of Agreement – Area of Focus
Auto - Renewal?
How many years?
Notice requirements – who notifies who
Termination clause
Review – allows for either employer or employee to terminate
Without Cause - requires 60-90 days
Moratorium – require employer keep you for 6 months
Termination for “Cause”
Read carefully
Look for reasons for dismissal
Should be clear and specified
Look for subjective open-ended provisions – “behavior is not in the best interest of
the practice”
If definitions are too loose ask they be eliminated or restricted
13
14. Devil is in the details!
Dispute Resolution
Mediation/Arbitration (binding/not binding)
Non-Compete Agreements
Almost all contracts contain
If you leave – you will not be able to practice in a certain area for a
certain time period
Louisiana enforces Non-Compete if it states the parishes
Look for reasonableness
You might not be able to eliminate this clause
May be able to limit to facilities when terminated for “Cause”
14
15. Devil is in the details!
Compliance with laws
Requirement for CMS
Inspection of records
Corporate Practice of Medicine
Governing Law – usually Louisiana – or location of hospital
Addresses venue, location of arbitration etc.
Assignment
Reassignment of claims to hospital or group
15
16. Devil is in the details!
Requirements for Partnership?
Time period
Financial Productivity
Buy in
Buy out
Ownership percentage (shares)
Voting rights
Distribution of practice revenue
Protocol for evaluating practice assets
Equipment
Property
Accounts Receivable
Tax Issues
16
17. Devil in the details
Partnership
New hires – usually have lower salary to obtain partnership
Should specify time doctor would be considered
Should specify requirements – productivity
Should specify “buy in”
Trial period – usually one year
Should contain annual or semi annual review of doctor’s work
Criteria should include:
Quality of medical care, nature and frequency of complaints, productivity
date – all should be described
What is being purchased? – Stock, Shares, Interest in Partnership?
Are assets part of the deal?
17
18. Devil is in the details!
Partnership (cont.)
“Buy In” Formula:
Hard assets – furniture, equipment,
A/R – Accounts Receivable
Goodwill
Patients now choose managed care based on costs rather than reputation
– so goodwill is less a factor and “buy ins” less expensive
If “buy in” is high –will group finance at low interest rates? – Look to
negotiating excess production beyond bonus to apply to “buy in”
Tax issues
Ask about Valuation of Practice
Book value v. FMV
18
19. Anatomy of a Physician Contract
Introductory Paragraph
Recitals
Agreement to Employ
Employment Duties
Compensation
Benefits
Term
Termination – By Employer/By Physician
Practice Standards
Facilities provided by Employer
19
20. Anatomy of a Physician Contract (cont)
Medical Staff Privileges
Reassignment Professional Fees
Medical Records
Disability
Restrictive Covenants
Disputes
Partnership
Misc Provisions
20
21. Anatomy of a Physician Contract
Introductory Paragraph:
The first section of the employment agreement should do three things: (1)
indicate the date the agreement is being signed; (2) precisely identify the
parties to be bound by the agreement; and (3) indicate the type of legal
entity through which the employer is doing business, e.g., a corporation or
a partnership.
Sample Provision: Introduction
THIS PHYSICIAN EMPLOYMENT AGREEMENT ("Agreement") is made and
entered into as of this _____ day of __________________, 20__, by and
between _______________________ Medical Group, [Inc.], a [insert the
state] professional medical [corporation/partnership] (hereinafter referred
to as "Employer"), and __________, M.D., an individual (hereinafter
referred to as "Physician"), with reference to the following facts:
21
22. Anatomy of a Physician Contract
Recitals:
The employment agreement typically will include some recitals designed
to express the intent of the parties in entering into the relationship.
Sample Provision: Recitals
A. Physician is a physician and surgeon, specializing in ___________ (e.g.,
internal medicine, cardiology, or radiology) who is licensed to practice
medicine in the State of ___________.
B. Employer is a professional medical [corporation/partnership] organized
under the laws of the State of ____________.
C. Employer desires to employ Physician on a full-time and exclusive basis to
provide professional medical services within the scope of Physician's
license and specialty to Employer's patients, and Physician desires to be so
employed by Employer and to provide such services to and on behalf of
Employer.
22
23. Anatomy of a Physician Contract
Agreement to Employ:
This provision sets forth the fundamental agreement of the parties to
enter into an employer-employee relationship. It should also specify
whether the relationship is full or part-time, and whether or not it is
intended to be exclusive or if the employee can enter into other
employment and contractual arrangements for physician services (e.g.,
moonlighting).
23
24. Anatomy of a Physician Contract
Agreement to Employ:
Sample Provision: Employment
Employer hereby employs Physician, and Physician hereby accepts
employment by Employer, for the purpose of providing professional
medical services, within the scope of Physician's license and specialty of
___________________, to Employer's patients. During the term of this
Agreement, Physician agrees that he or she shall render such professional
medical services to Employer as an employee on a full [part]-time and
[non-]exclusive basis in accordance with the terms and provisions of this
Agreement. Physician agrees that he or she shall not render professional
medical services to any other person or party during the term of this
Agreement, without prior notice to and approval of Employer.
24
25. Anatomy of a Physician Contract
Employment Duties
This section should set forth in some detail what clinical and
administrative duties the physician is expected to perform. The physician's
work schedule (including specific days of the week and hours) should be
described. Alternatively, this section could provide that the physician is
required to work whatever hours are necessary to discharge his or her
employment duties.
25
26. Anatomy of a Physician Contract
Employment Duties (cont.)
On-call responsibilities can be described in several ways including, for
example: every fourth night and weekend; equal to the employer's other
physician employees; or as scheduled by the employer from time to time.
Generally, employers will want to maximize their flexibility to schedule on-call
coverage, and physician employees will want to limit the employer's ability to
do so. What is most important is that the parties come to a clear agreement
on this point.
If the employer expects the physician to assist with practice management,
marketing, and other administrative tasks, this should be specified and agreed
upon as well.
See Example FORM RVU K
26
27. Anatomy of a Physician Contract
Compensation
Obviously, the physician employee's compensation is a key term of the
employment agreement. Compensation provisions vary widely from
straight salary (e.g., $150,000 per year) to complex production formulas. It
is not uncommon to have a mixed formula that combines a base salary
plus a bonus that is either at the employer's discretion or based upon the
physician employee's productivity. Development of a compensation
formula that incentivizes desired physician behavior is critical to the
success of any medical group or other employer.
.
27
28. Anatomy of a Physician Contract
Compensation (cont.)
Production Based
If a production-based formula will be used (such as paying the physician a percentage of
the collections they generate), the formula needs to clearly define what collections will
be credited to the physician. For complex formulas, examples should be included in the
agreement.
In any production-based formula, it is also important to provide how post-termination
collections will be handled. Will a departing physician be credited with post-termination
collections for services that he or she rendered before leaving? If so, for what period of
time? Will any post-termination expenses, such as collection costs, be charged to the
departing physician?
.
28
29. Anatomy of a Physician Contract
Compensation (cont.)
Profit Based
If some or all of the physician's compensation will be based upon "profit" generated by
the physician, then the employment agreement needs to describe in detail how
revenue and expenses will be determined and allocated. For example, some employers
will allocate certain expenses, such as rent, equally among group members; other
expenses, such as supplies, based upon the physician's percentage of the total
collections of the group; and some may be allocated 100% to the physician, such as
continuing medical education costs. It may be useful to review the employer's financial
statements line-by-line to insure that all sources of revenue and expense are accounted
for in a "profits"-based formula.
FYI- In order to avoid physicians "cherry picking" the best paying patients, some employers may allocate
revenue based upon the physician's share of the total relative value units generated by the group.
29
30. Anatomy of a Physician Contract
Benefits
In addition to cash compensation, most physician employees are provided with certain
benefits. The employment agreement, therefore, should describe any benefits that the
employer will provide including items such as malpractice insurance, health insurance,
memberships and dues, and time off.
Common Paid Expenses
Many employers pay or reimburse physician employees for some or all of the following
benefits: malpractice insurance; retirement plans; health, dental, vision, life and
disability insurance; medical staff dues; medical license fees; medical and specialty
association dues; automobile expenses; cell phone monthly charges; professional
journals; continuing medical education tuition, travel, lodging and meal costs;
marketing and promotion expenses; and moving expenses.
SEE FORM RVU K
30
31. Anatomy of a Physician Contract
Benefits (cont.)
Paid time off…..
The employment agreement should specify how much time off the physician may take.
However, the amount of time is only one of several issues that need to be considered.
• Will the time off be paid or unpaid?
• Will the amount of permitted time off increase as the physician gains seniority?
• Will there be separate categories of time off for vacation, holidays, sick days, personal days, and
continuing medical education?
FYI - The trend is toward combining some or all of these categories under the heading of
"paid time off."
• How many non-sick days may be taken off at one time?
• How much notice should the employee be required to give before taking time off?
• Will unused time off accrue indefinitely or only up to a predetermined cap, or does the employee lose all
time off that is not used each year?
31
32. Anatomy of a Physician Contract
Benefits (cont.)
Paid time off…..
• Is the employee entitled to all of his annual time off as of the beginning of each
contract year or does time off accrue ratably over the year?
• Upon termination of the physician's employment is he or she entitled to be paid for all
accrued time off?
• Should the employee be required to repay the employer upon termination if the
physician has taken off more time than that to which he or she was entitled?
A separate issue is whether the employee will be entitled to additional time off in the
event of a disability and, if so, how much time? - to be discussed later…..
32
33. Anatomy of a Physician Contract
Benefits (cont.)
Liability Insurance – who pays?
A host of issues have to be considered when drafting employment agreement provisions
regarding professional liability (malpractice) insurance.
Will the insurance be paid for by the employer or the employee physician?
Generally, the employer pays.
How much coverage will be purchased?
Typically, this is expressed as one amount per claim (e.g.,
$1 Million) and a separate amount in the aggregate for the policy year (e.g., $3
Million).
33
34. Anatomy of a Physician Contract
Benefits (cont.)
Liability Insurance – who pays? (cont.)
What kind of coverage will be provided, "occurrence" or "claims made?"
• Occurrence - With an occurrence policy the physician employee is covered for claims
that arise out of the physician's acts or omissions while employed even if the claim is
not made until after the physician's employment has terminated
• Claims Made - A claims made policy, on the other hand, provides coverage only for
claims that both arise out of conduct occurring during the physician's employment and
which are made while the physician is employed by the employer
34
35. Anatomy of a Physician Contract
Benefits (cont.)
Liability Insurance – who pays? (cont.)
Nose/Tail Coverage -
In order to have protection for claims that are filed after the physician's employment terminates, an
extended reporting endorsement (tail) policy or prior acts or retroactive coverage (a "nose") may have to
be purchased.
Tail - A tail is generally purchased in connection with the policy that covered the physician while employed
by the now former employer. The employment agreement should also specify how many years post-
employment the tail is to cover.
Nose - A nose is usually purchased as part of the coverage through the physician's subsequent employer.
35
36. Anatomy of a Physician Contract
Benefits (cont.)
Liability Insurance – who pays? (cont.)
Important Note: Tail Coverage -
The employment agreement should indicate whether the employer or the physician is
required to purchase a tail policy upon termination of the employment relationship. The
agreement might provide that it depends upon the circumstances of the termination. For
example, the employer might be required to purchase the tail if the physician is terminated
without cause; and the physician employee pays if he or she terminates without good cause.
The agreement could also provide that the parties split the cost of the tail policy.
36
37. Anatomy of a Physician Contract
Term
A basic provision of any contract is its duration or term. Accordingly, the employment
agreement should specify when it begins and when it ends, e.g., July 1, 2009 through
June 30, 2010. Absent a specific term, an employment agreement would likely be
viewed as being terminable at the will of either party.
The "effective date" (when the parties become mutually obligated to each other under
the agreement) may be different from the start of the term which is usually when the
physician begins work under the employment agreement. The employment agreement
might provide that the term does not commence until a certain event occurs, such as
the physician employee becoming licensed in the state or obtaining malpractice
insurance or medical staff privileges.
37
38. Anatomy of a Physician Contract
Termination
Regardless of the length of the term, most employment agreements allow
for early termination under certain conditions. Termination provisions
generally fall into three broad categories: (1/2) termination with or
without cause upon a specified number of days' prior written notice, e.g.,
30 to 90 days; termination for a material breach of the agreement subject
to an opportunity to "cure" or correct the breach; and (3) immediate
termination for certain very serious problems
38
39. Anatomy of a Physician Contract
Termination – Without Cause
Employers generally want the right to be able to terminate a physician
employee without having to state a cause. The reason is simple: If the
employer has to state a cause, the employee can argue that the employer
is wrong and that no such cause exists.
Employees may also want a without cause right so that they may
terminate the relationship early even if the employer is meeting its
obligations under the employment agreement.
Either way – The amount of notice required needs to be specified.
39
40. Anatomy of a Physician Contract
Termination – For Breach
As a matter of general contract law, if one party does not perform its material
obligations under a contract, the other party will have the right to terminate the
contract. Nevertheless, most employment agreements specifically provide that if one
party breaches a material term or condition, the other party can give it written notice
that unless the breach is cured within the notice period (usually 15 to 30 days), the non-
breaching party can terminate the agreement.
Sample Provision: Termination for Breach
Notwithstanding Sections ___ or ___, this Agreement may be terminated by either
party for cause upon the material breach of this Agreement by the other party, if such
breach is not cured within fifteen (15) days following written notice of such breach.
40
41. Anatomy of a Physician Contract
Termination – Immediate
There are some events which are so serious that immediate termination without prior
notice is necessary to protect the employer and the patients, such as in the event of
loss of medical license, malpractice insurance, or medical staff privileges, exclusion from
the Medicare program, endangerment of patients, or acts of dishonesty.
Immediate termination should be listed in agreement – specifics as to what constitutes
immediate termination
See FORM RVU K
41
42. Anatomy of a Physician Contract
Compliance
It is obviously important to an employer that the physician employee have
the proper license, board certification, and other credentials and not have
prior legal problems. The employer could be liable for "negligent
credentialing" if the employer does not take reasonable steps to check the
background of the prospective physician employee to ensure that he or
she is properly credentialed. The employment agreement should also
contain various representations and warranties from the physician
employee to provide further assurance regarding these matters.
42
43. Anatomy of a Physician Contract
Facilities
The employment agreement should contain a commitment from the
employer to provide the physician employee with the necessary facilities,
equipment, supplies, and personnel to carry out his or her duties under the
agreement. From the employer's perspective, the commitment should be
general. If the physician employee is expecting specific or unusual items of
support (such as a new and expensive piece of medical equipment or specially
trained support personnel), however, this should be stated explicitly in the
agreement.
43
44. Anatomy of a Physician Contract
Medical Staff
Most employment agreements require that the physician employee obtain and maintain medical staff
privileges at one or more hospitals. As noted above, the agreement might also provide that its term does
not commence unless and until the physician obtains the necessary medical staff privileges.
Sample Provision: Medical Staff Privileges
Physician shall maintain at all times during the term of this Agreement, membership on the medical staffs
of ____________ Hospital and ____________ Hospital, and at such other hospitals and facilities as
Employer shall specify from time-to-time, with all medical staff privileges necessary to enable Physician to
provide the services required of Physician pursuant to this Agreement.
44
45. Anatomy of a Physician Contract
Assignment of Fees
The employment agreement should provide that the physician employee
assigns all rights to bill and collect to the employer. The physician employee
should also agree to submit accurate and complete billing information in
connection with all professional medical services that the physician renders
pursuant to the employment agreement.
See FORM RVU K
45
46. Anatomy of a Physician Contract
Medical Records
The medical records provision in the employment agreement should address at least three things:
(1) the physician employee's obligation to complete the medical records,
(2) ownership of the medical records, and
(3) maintaining the confidentiality of the medical records.
The agreement may also provide that upon its termination, subject to compliance with applicable federal
(e.g., HIPAA) and state law, the physician will have access to the medical records for reasonable purposes
such as malpractice defense or if the patient wants to transfer the records to the physician's new practice.
In that event, the employment agreement should indicate who is responsible to pay for copying the
records.
46
47. Anatomy of a Physician Contract
Disability
The employment agreement should address the rights and obligations of the parties if the
physician employee becomes disabled. Disability provisions can raise many complex and
difficult issues including the following:
• How is disability defined?
• For instance, does it mean that the physician is unable to perform "substantially all" of his or her regular employment
duties
• How many days does the physician have to be unable to work before he or she can be
considered to be disabled (e.g., 60, 120, or 180)?
• Do these days have to be consecutive or will it be sufficient if a cumulative total is reached during any twelve month
period of the employment agreement?
• In the event of a dispute, who determines whether the employee is disabled? Frequently, an
impartial, outside physician makes the determination.
47
48. Anatomy of a Physician Contract
Disability (cont.)
The employment agreement should address the rights and obligations of the parties if
the physician employee becomes disabled. Disability provisions can raise many complex
and difficult issues including the following:
• What compensation, if any, will the physician employee be entitled to receive while
disabled?
• How will benefits be treated during the period of disability?
• Depending upon the size of the employer, any termination for disability needs to
comply with applicable state and federal law (e.g., the Americans with Disabilities Act
and Family and Medical Leave Act).
48
49. Anatomy of a Physician Contract
Restrictive Covenants
Restrictive covenants can take a number of forms including exclusivity
requirements; non-disclosure agreements; non-solicitation provisions; non-
interference agreements, and covenants not to compete. Typically, the
employer will want to include broad restrictive covenants to protect its
practice. Employees, of course, will want to limit the scope of any restrictive
covenants particularly those that could apply post-termination.
49
50. Anatomy of a Physician Contract
Disputes
When an employment relationship ends other than with the consent or
agreement of both parties, the potential for a dispute is present. It is, therefore,
important to consider what dispute resolution mechanisms to include in the
employment agreement. If no dispute resolution provisions are agreed upon, then
either party will likely have the right to file a lawsuit in court.
Arbitration:
The principal alternative to having the right to file a lawsuit in court is to require
that all disputes be submitted to binding arbitration - usually a trial setting
Mediation:
In mediation, the parties usually meet with an attorney (with or without judicial
experience) who tries to help them reach a voluntary settlement of their dispute.
50
51. Anatomy of a Physician Contract
Ownership
Most physicians who join a medical group do so with the hope and expectation of becoming an owner,
either as a partner in a partnership or a shareholder of a professional corporation. At the same time, most
employers do not want to be contractually bound to eventually making all new physician employees
owners. The compromise that is often reached is for the employer to commit to considering the subject of
ownership within a specified period of time, e.g., within two years of the commencement of the
physician's employment. In order to reduce the likelihood of surprise and disappointment, it may be useful
at the beginning of the employment relationship to give the physician some idea of what he or she will be
expected to accomplish in order to be considered for an equity position. Other terms that might be
discussed include the buy-in price or formula, how that price will be paid, and the percentage of
ownership that may be offered.
.
51
52. Anatomy of a Physician Contract
Misc Provisions
Assignment:
Most employment agreements provide that they cannot be assigned by one party
without the other party's consent. In some cases, however, the employer may want the
right to assign the employment agreement in the event of a sale or merger.
Amendments:
The employment agreement should provide that it can be amended only in writing.
.
52
53. Anatomy of a Physician Contract
Misc Provisions (cont.)
Entire Agreement:
The employment agreement should include an integration or merger clause providing that
the agreement represents the entire agreement of the parties and supersedes any prior
understandings or agreements. If other agreements or documents (e.g., a policies and
procedures manual) are intended to also be followed by the parties, they should be
specifically referenced in the agreement or attached as an exhibit.
53
54. Anatomy of a Physician Contract
Misc Provisions (cont.)
Notice:
It is important to specify how any written notices required under the
employment agreement are to be given in order to be effective. For
example, prior notice is usually required to terminate the agreement. The
mechanism for giving the notice should be described which could include
personal delivery, regular U.S. Mail, certified or registered mail, private
delivery service such as Federal Express, or by facsimile (with proof of
receipt).
Governing Law:
This is almost always the law of the state where the employer and
physician are located. But the choice may not be obvious if the employer
operates in more than one state.
54
55. Anatomy of a Physician Contract
Misc Provisions (cont.)
Severability:
The parties generally want to provide that if one portion of the employment agreement is
found to be unenforceable, the remainder of the agreement will not be voided. But the
drafting or reviewing attorney should also consider whether the rule should be different if
the provision that is unenforceable denies one party the benefit of the bargain. In that case,
the adversely affected party might be given the right to terminate the agreement.
Other Misc Provisions – there might be other provisions contained in the agreement and it is
best to work with your healthcare lawyer to review the same when reviewing your
employment contract!
55
57. Devil is in the details
Red Flags
An abbreviated contract – does not cover key issues – compensation,
grounds for termination, benefits, vacation, or sick leave
A group that attempts to rush you into an agreement
A prospective employer who suggests that you don’t need an attorney
A contract that offers you something substantially different than what
others in the group are accepting
A one sided deal favoring the group/hospital
A contract that does not mention partnership
57
58. 58
Questions or Comments please contact:
Conrad Meyer Esq., MHA FACHE
Sarah J. L. Christakis, Esq., J.D., L.L.M.
Chehardy Sherman, LLP
cm@chehardy.com
sjlc@chehardy.com
(504) 833-5600