The Medical staff counselor
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This article--the second in a series analyzing the physician-hospital contracting process from the physician's perspective--addresses negotiation of specific contract terms, including such controversial issues as exclusive contracts, mandatory managed care arrangements, and tie-in of contract terms and medical staff privileges. Also discussed are the goals and expectations of physicians and hospitals during the contracting process.
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This article--the third in a series analyzing the physician-hospital contracting process from the physician's perspective--addresses the legal issues involved in physician-hospital arrangements, including those arising under federal and state illegal remuneration, antitrust, and tax laws. New applications of these issues to physician-hospital organizations and practice management/practice acquisitions by hospitals are also addressed, as well as other recent hospital efforts to maximize the benefits to be gained from the physician-hospital relationship.
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The occasional imposition of antitrust liability on medical staff members for actions involving peer review is not a sufficient reason to abandon medical staff participation in the peer review process. This article reviews some of the case law in which the applicability of the intracorporate conspiracy doctrine to medical staff peer review activity has been decided and explains why appropriate medical staff involvement in such activity does not raise the risk of antitrust liability.
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This is the second part of a two-part article examining the federal patient anti-dumping statute, under which physicians are required to treat a hospital's emergency patients, including women in labor, and to comply with certain requirements that dictate when it is appropriate to transfer a patient. Part I discussed in detail the provisions of the statute. Part II analyzes various court interpretations of the law and its potential impact on physician liability.
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Physicians often find themselves the victims of uninformed peer review practices whereby hospital boards make decisions regarding medical staff privileges without adequately evaluating the charges and without affording physicians the appropriate due process protections. In addition to damaging a physician's reputation, such unfair review practices can lead to liability exposure and expensive and prolonged litigation. This article describes how medical staff physicians and hospital board members can avoid these problems by taking an active and informed role in the peer review process.