Read This or You'll Go to Jail

Plus: I predict the future

Author

Kyan Lynch
October 27, 2024 • Estimated Reading Time: 8 minutes

👋Hey, it's Ky. If you’re reading this, you could probably use a pat on the back for all your hard work.

So, go ahead, give yourself a pat - you’ve earned it!

Subjective: A Sneak Peek at the Future

I got to do one of my favorite parts of the job this past Monday.

My colleagues and I gathered around a big, granite-topped table to get to know the future Ob/Gyns of America.

One by one, the Program Director and Associate Program Directors presented the applications submitted to our residency program, offering a brief overview of each applicant—their background, accomplishments, and goals for the future.

I’ve got to say: these applicants are incredible.

Some have already had successful careers and are now applying those lessons to medicine.

Others are earning additional degrees while still in med school - MPHs, MBAs, you name it.

Some have served in the military, AmeriCorps, or the Peace Corps.

They’re all passionate about Ob/Gyn and understand how significant this moment is for the field.

One of my favorite things to review is the "Hobbies" section.

It not only shows how well-rounded these applicants are but also gives a snapshot of the broader cultural moment.

For example, just 3-4 years ago, listening to true crime podcasts 🗡️ was one of the most popular hobbies. This year, we saw a lot of houseplant nurturing🪴and crochet🧶.

What does that mean for next year’s intern class? I’m not sure, but it sounds cozy!

Objective: How to Not Break the Law

It’s important to be self-aware. To know about your strengths and weaknesses.

For example, I’m not a cook. I once tried to make rosemary fingerling potatoes in a pan without boiling them first. Didn’t work.

I’m also not an electrician. I once tried to remove a light switch and ended up shocking myself and my refrigerator. There are still burn marks on the fridge, 3 years later. Ask me for a picture if you don’t believe me.

I’m also not a lawyer. Like not even a little. I couldn’t even play one on TV.

Fortunately, that’s what friends are for.

The Compliance for Clinicians Newsletter wants to help you stay out of jail.

I’ve been a reader for a few weeks now, and here are 3 things I’ve learned:

1) The Federal Trade Commission (FTC) will go after you for fake reviews or testimonials

You may have noticed that a lot of healthcare professionals’ websites look like Yelp! now.

There are star ratings and patient testimonials galore.

I didn’t know that the FTC has rules governing those reviews! But it sure does.

Just a few of the no-nos:

🚫 AI-generated reviews
🚫 Implicitly or explicitly incentivizing positive (or negative) reviews
🚫 Reviews submitted by managers or officers
🚫 Soliciting reviews from family members
🚫 Hiding negative reviews so the overall impression is more positive

2) The difference between credentialing and privileges

This one might be old news to some, but I had smooshed the concepts of credentialing and privileges together in my head.

But they are different! Here’s how:

Key Questions

Goals

Process

Credentials

* Are you who you say you are?

* Do you have the education, training, licensure, and qualifications you say you have?

* Patient safety

* Reputational risk mitigation

1. Clinician submits application

2. Institution verifies information

3. Committee review

4. Approval or denial

Privileges

* What procedures and services will you perform?

* What does your proposed role require that you do?

* Patient safety

* Logistical and operational needs are met

* Role clarification

1. Identification of needed privileges

2. Medical staff review; approves or denies

3. Reassessment and reappointment every 2-3 years

3) Corporations can’t own medical practices

Apparently, there’s something called the Corporate Practice of Medicine (CPOM) doctrine.

This doctrine is like the separation of church and state but for healthcare. It says that corporate entities and non-physicians cannot own or control a medical practice. 

Here is actual footage of me reading that for the first time:

If non-physicians and corporations aren’t allowed to own medical practices, why is (almost) everyone I know employed by a corporation? And why do I keep reading about private equity taking over healthcare?!

I reached out to Sarah Covington, a lead contributor to Compliance for Clinicians, because IM CONFUSION.

That’s when she told me to read the part about Management Service Organizations (MSOs), a term that, I’ll admit, caused my eyes to glaze over and my mind to project an image of a dancing monkey.

Long story short, there are ways of structuring things so that a physician owns the practice on paper, but the MSO pulls the business strings. And the physician can’t sell the practice without MSO approval.

Sneaky.

So then I asked about the big health systems gobbling up practices left, right, and center, and she told me that health systems are exempt!

Naturally, I asked what the definition of “health system” is, and told her that I needed the kindergarten version.

Sarah said, “Haha simplest answer is owning a hospital”.

There’s a lot that I didn’t know… are we teaching medical students and trainees enough about healthcare law? Reply with your thoughts!

Assessment: Quick Quiz!

What percentage of residents are in a union?

US only, as of Oct. 2024

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⏪Last Week’s Question:

What is the recommended maximum number of inpatient consultations trainees should perform per shift to avoid cognitive overload?

Answer: 4, according to this study

Plan: Upcoming Dates & Events

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P.S - Have you ever thought about sharing your expertise more widely, and even earning extra income doing so? If so, you’ll love the freebies I have for you on my website, kyanlynch.com