Rural Hospitals Hope to Change Hiring Law
A Texas law dating back to the 1800s that keeps hospitals from directly hiring doctors comes up before lawmakers again today, in a flurry of bills designed to remove the ban — either for an individual hospital district, or for all the state's rural hospitals.
Supporters of the “corporate practice of medicine” law say the rule keeps doctors independent, and keeps hospitals from meddling in the care a doctor gives their patient. Opponents argue the law — which already has exceptions and work-arounds for many hospitals — is hurting rural facilities that struggle to recruit doctors.
Don McBeath, director of advocacy for ...
Comments (3)
stlevine
Employment of physicians by hospitals is not the answer -- and certainly not the only answer -- to bringing doctors to rural parts of Texas. Our 2003 liability reforms have helped quite a bit. We've started to see some help from the loan repayment program the Texas Legislature passed in 2009, but which are in jeopardy this year.
For proof of how loan repayment programs can help (this is a federal program), check out this short video from Dr. Adrian Billings, a family medicine physician in Alpine, Texas. "God put me on this earth to become a physician and to go back to the Texas-Mexico border."
http://www.youtube.com/watch?v=vZh77g8lsHI
Steve Levine
Texas Medical Association
Rudy Gonzales
Texas has lagged other states in removing this law from the books and Texans have suffered. Our career governor and the one party legislature have tied the hands of rural hospitals and physicians.
Under one party rule in Texans have fared poorly in other areas and we cannot afford to keep letting Austin tie our hands. If we had "Initiative and Referendum" here in Texas, WE could get things done without Perry or the Legislature. WE could do what needs to be done and even pass legislation to limit career politicians like Perry to two terms. Here's how we stand in a nationwide analysis:
— Tax expenditures per capita (47th)
— Percent of population 25 and older with a high school diploma (50th)
— Percent of poor people covered by Medicaid (49th)
— Percent of population with employer-based health insurance (48th)
— Per capita spending on mental health (50th)
— Per capita spending on Medicaid (49th)
— Percent of non-elderly women with health insurance (50th)
— Percent of women receiving prenatal care in first trimester (50th)
— Average credit score (49th)
— Workers' compensation coverage (50th)
— Number of executions (1st)
— Public school enrollment (2nd)
— Percent of uninsured children (1st)
— Percent of children living in poverty (4th)
— Percent of population uninsured (1st)
— Percent of population living below poverty (4th)
— Percent of population with food insecurity (2nd)
— Overall birth rate (2nd)
— Amount of carbon dioxide emissions (1st)
— Amount of toxic chemicals released into water (1st)
— Amount of hazardous waste generated (1st)
Ed Uthman
Thanks for the very nice article. However, it does not mention what is arguably the dominant proximate cause behind the effort to repeal the ancient prohibition of the "corporate practice of medicine."
The real reason is that in the last decade, physicians have reacted to declining reimbursements by building their own outpatient endoscopy and surgery centers, clinical laboratories, imaging centers, and long-term acute care facilities (LTACs). Since the physician controls the patient flow, he or she can self-refer the cream of the payer mix to his or her own facility. The dregs are left to the community hospitals and their emergency departments, which by Federal law must accept anyone who walks in, irrespective of ability to pay. The inevitable result is that community hospitals are in the process of going extinct.
The attempt to repeal the law forbidding the corporate practice of medicine is just an effort by community hospitals to survive. With the deck stacked against them, the only way for the hospitals to compete is to hire their own doctors to insure that some patients other than the impoverished, the financially irresponsible, and undocumented aliens can be admitted to the hospitals for elective procedures, which is the only component of health care that doesn't lose money. If it were illegal for physicians to refer patients to facilities the physicians own, the playing field would be level, and there would be no need for this remedial legislation.