As the healthcare and life sciences industries continue to undergo sweeping regulatory change, your practice might be facing unprecedented structural and operational challenges.  Adherence to the evolving maze of laws and regulations must be your paramount concern. From a business perspective, the industry is experiencing a period marked by rapid consolidation that is pushing transactional issues front and center.

James C. Brock, a healthcare attorney in Orlando, Florida, is uniquely positioned to guide clients through these challenging times. He doesn’t just dabble in healthcare law. Being a healthcare attorney who is dedicated to practicing healthcare law has its own value, and, as a result, he is well-versed in the many day-to-day issues confronting the healthcare law industry. The breadth and depth of his knowledge and experience informs his advice in related litigation, transactional, and investigative matters. He also draws on a wide range of related practices as the need arises. This cross-disciplinary approach allows him to solve the multitude of problems his clients face. He knows your business. He knows your industry.

Physicians who are opening their practices, forming partnerships, renting office space or simply considering financial/space arrangements with existing healthcare providers are confronted by a multitude of legal, administrative, and tax considerations. These are activities that require the help of a health lawyer who specializes in the medical field.  These are potentially serious matters that you should definitely NOT try on your own.

For instance, physicians who participate in Medicare are subject to the “Stark Law” rules which, in effect, require that agreements between health care providers and physicians meet the “fair market value” test.  A federal court recently ruled that when a hospital allowed a physician to use its resources (e.g., exam rooms, nursing personnel, and supplies) when treating hospital patients, such free use constituted remuneration and was thus considered part of his/her compensation package.

The proper corporate organization for your practice can serve save your assets from predatory litigation. Properly formed, your corporate organization can also lawfully and ethically avoid significant tax obligations as your practice grows. Note: Although I do not personally specialize in tax law, I have a longstanding relationship with a certified public accountant who works almost entirely with individual physicians, physician practices, and hospitals.

The foregoing is just a brief review of some of the numerous issues that need to be addressed in the formation and eventual operation of a successful practice.  Mr. Brock looks forward to being your trusted advisor in such matters.

Notes & Comments​

The pre-eminent Florida “Medical Malpractice” law firm of Searcy, Denney, Scarola, Barnhart & Shipley, based in West Palm Beach, recently announced the favorable settlement of a case involving the death of a surgery patient following an overdose of the pain medication, Fentanyl.  Its chief hazard is hypoventilation or respiratory suppression.  This case should be a wake-up call for all hospital administrators respecting the need for improved protocols to ensure that doctors, pharmacists, and nurses are fully aware of the drug’s potency and contraindications.

According to the firm, a woman who was experiencing “moderate” post –operative pain, was given a 50 mcg/hour Fentanyl pain patch by her anesthesiologist. It was approved by the hospital pharmacist and applied by a hospital nurse. The patient was then discharged without any post-operative instructions regarding the patch. She died the second night following surgery; the Medical Examiner later concluded that Fentanyl in her blood system contributed to her death.

Fentanyl, which is 100 times more potent than morphine, contains “black box warnings” from the FDA prohibiting its use in patients who are not opioid dependent and is intended to treat only acute pain, or for the treatment of post-operative pain following outpatient surgery.  There is no indication in the firm’s summary of the case that the patient in question was opioid

dependent.

In the legal proceedings which followed, the anesthesiologist admitted that he had an “incomplete” understanding of the contraindications for the use of Fentanyl and that he had never before ordered the patch under similar circumstances. The hospital pharmacist testified that she did not “thoroughly evaluate” the prescription and simply relied on the doctor’s expertise. The nurse who administered the patch admitted that she did not know that Fentanyl patches came with “black box” warnings.

It is often said that modern airliner crashes only occur from a series of often unrelated events which lead to disaster. Obviously, that theory applies in the medical environment as well. It seems almost incomprehensible that three medical professionals, all of whom worked in the same hospital, were not fully aware, whether on their own volition or though effective hospital advisories and/or protocols, that Fentanyl came with the FDA’s  highest level of warnings that can be required of prescription drugs.