Business Savvy Reading List
Stay current on trends and build your business and
legal
understanding through regular reading of key resources.
The fun and frivolity of summer are over. For so
many grade school, high school, and college students, it’s back
to the books. While some students may not be stimulated by topics such
as history, geography, or math, this information lays the foundation
for understanding the world in which they live, and helps develop
knowledge that will enable them to be productive adults.
So, although business and
legal topics may not be your favorite subjects to brush up on in your
leisure time, as a physician, your responsibility to learn and
understand legal and business concepts and keep up with industry trends
has never been more important. This knowledge will make you a more
attractive potential colleague or partner, and may even assist you in
becoming a better physician. This article provides reading resources
that will help you build your understanding of the business of
medicine. Like other professions, medicine is a business—a
multi-billion dollar business, in fact.
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Internet Bookmarks
Add these sites to your
browser's bookmarks
so you can check them
regularly.
U.S. Department of Health and
Human Services
www.hhs.gov
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Many physician clients and
contacts have asked me to compile a list of non-clinical resources that
will help them learn more about the law and business of medicine. They
realize that their financial success as physicians is often directly
related to their ability to effectively navigate its legal and business
issues.
This is not an exhaustive list
of all the worthwhile legal and business sources in existence, but they
are sources that I regularly review to gain additional insights to the
business issues in our health-care delivery system. This information
makes me a more well-rounded lawyer and better equipped to advocate for
my clients. I have no financial relationship with any of the sources
named.
Since your spare time is
limited, I have focused on sources that have Internet addresses (you
may need to register for some). You can easily bookmark these sites and
periodically check back for new and important developments. Many of
these Web sites have a section entitled “What’s New”
or something similar so you can quickly find out about new trends and
developments.
Health-care laws and initiatives
A significant portion of our health-care dollars
is dedicated to federal and state programs. The Centers for Medicare
and Medicaid Services (www.cms.hhs.gov) administers the Medicare program and works with
individual states to administer the Medicaid program and various other
federal-state initiatives. The CMS Web site includes a plethora of
useful information. There are specific categories designed for
“professionals” and “consumers” and a
frequently-asked-question and answer section containing almost 3,000
queries. The CMS site includes folders categorized by program (e.g.,
Medicare, Medicaid), topic (e.g., coverage decisions, Medicare
Modernization Act), and a resources section that includes a
comprehensive glossary of health-care terms, various CMS forms, and
statistical information.
CMS is located within the U.S.
Department of Health and Human Services (www.hhs.gov). Like CMS, the HHS Web
page has a great deal of useful information. The HHS Office of
Inspector General’s site (http://oig.hhs.gov/) is a frequent destination for health-care lawyers and
practitioners looking to gather information related to the most recent
anti-kickback advisory opinion, government fraud alert, or hearing
testimony before a congressional committee. The HHS OIG publishes the
annual work plan (http://oig.hhs.gov/ publications/workplan.html#1) that sets forth various
projects and initiatives to be performed by HHS. The annual work plan
is often a good way to learn more about the federal government’s
enforcement and fraud and abuse focus for the upcoming year. The HHS
Office of Civil Rights has responsibility for ensuring HIPAA Privacy
Compliance and its Web page (www.hhs.gov/ocr/hipaa/) has an extensive section
of Frequently Asked Questions and various educational materials.
Depending on where your
practice is located, your state government may have a useful Web site
that profiles important health-care statutory and regulatory
developments. Some states include their state statutes and/or
regulations on the Web. If there is a particularly important piece of
legislation enacted, the state government or state legislature Web page
may contain a copy of the statute and/or regulation. Note that many
states’ statutes and regulations are not otherwise available
without paying a fee for on-line research.
The Board of Medicine in each state
may be an important resource for issues affecting your medical
practice. A link to each state medical board’s URL can be found
on the American Medical Association Web site at www.ama-assn.org/ama/pub/category/2645.html.
To obtain a macro update for
state-level issues affecting physicians as well as other areas of
health-care law, the Web page for the National Conference of State
Legislatures (www.ncsl.org) profiles many important health-care issues that are
being debated or implemented in states across the nation.
Medical organizations
In addition to providing useful clinical
information, medical society Web sites usually include some information
about the business of medicine. Many of the Web pages provide public
access to documents so you are not restricted from access even if you
are not a dues-paying member. The Web page for the American Medical
Association (www.ama-assn.org/) includes a newsroom section with a number of
interesting sub-links and a separate section of professional resources
and standards, including practice management tools. The AMA site also
includes a legal section for physicians (www.ama-assn.org/ama/pub/category/4541.html). A list of the AMA state
affiliates can be retrieved at www.ama-assn.org/ama/ pub/category/7630.html.
The American Board of Medical
Specialties’ Web page (www.abms.org) profiles the activities of this organization and has
links to its 24 approved medical specialty boards in the United States.
Information for each of these boards is located at www.abms.org/member.asp.
The business of medicine
For those of you entering or switching to another
private medical practice, understanding the mechanics of how to run a
successful practice—financially, administratively and
clinically—will make you an important resource for your partners,
staff, and referral sources. The Medical Group Management Association (www.mgma.com) is a national association
for those individuals who lead and manage medical practices. Physicians
Practice (www.physicianspractice.com) promotes itself as the business
Web site for physicians. Their site includes the following categories
of information: billing and collections, coding, finance, human
resources, legal, operations, strategy, and, technology. WebMD’s
Medscape Business of Medicine Web page (www.medscape.com/businessofmedicinehome) includes a section on
“today’s news” and specific articles related to the
business of medicine. Of course, I would be remiss if I did not mention
Unique Opportunities, The Physician’s Resource site (www.uoworks.com) as an excellent source
for legal, policy, and other types of information.
Other useful sources
Health-care trends and important statutory and
case law developments may be marginally addressed in your local
newspaper. Some of the national newspapers have dedicated health-care
industry writers who provide in-depth analysis of emerging issues.
Newspapers that you may wish to periodically review include: The
Washington Post (www.washingtonpost.com), The New York Times (www.nytimes.com), and The Wall Street
Journal (http://online.wsj.com/ public/us).
The hospital(s) with which you
have staff privileges may publish a regular newsletter profiling
important community policy and/or legal developments. The
pharmaceutical sales representatives and other third-party vendors who
visit your office may provide you with a single page “white
paper” about a new development affecting their interaction with
you.
As students, we all sought to
gather as much information as possible from our teachers and learn from
their experiences. Your current cadre of professional
advisers—accountant, banker, insurance broker—may have
useful tax, financial, or investment information that can benefit you
and your practice. If you consult with a health-care attorney, he
should be able to provide you with cogent and timely legal advice about
a proposed business initiative or opportunity that has presented
itself. The attorney also may have ready access to articles he has
written about a particular issue or ones he has found useful in
explaining an issue in a non-legal format.
Maintaining a student philosophy
As a professional in the workplace, you are
expected to sharpen your clinical skills during the course of your
career. There is no summer vacation from gaining additional knowledge.
You will differentiate yourself from your physician colleagues if you
demonstrate an understanding of the legal parameters and political
climate in which you practice as a physician. Whether you are employed
by a large academic medical center, community hospital, pharmaceutical
company, a single-specialty or multi-specialty group practice, or as a
sole practitioner, you need to be aware of the multivariate issues
affecting the business of medicine.
This learning process is not an
exercise in cramming information into your short-term memory only to
regurgitate it later. Rather, this additional knowledge constitutes the
building blocks for your long-term success, regardless of the stage in
your professional career. You can identify and be ready to take
advantage of entrepreneurial opportunities by increasing your knowledge
of the legal and business issues confronting you and your colleagues.
Staying ahead of the learning curve is an important barometer for
success. While you will never be a tested, per se, on the knowledge you
have gained through these extracurricular studies, you will become a
more informed physician and more effective at protecting your
interests. The learning process never ends, it just changes. g
Bruce D. Armon is a partner who
practices corporate health-care law for Saul Ewing LLP. He is a
frequent speaker to physician audiences. Bruce can be reached at barmon@saul.com.
