Public Health Law Map - Beta 5 - Medical and Public Health Law Site

elationship is under pressure from medical businesses and third-party payers who
seek to influence the decisions of medical care practitioners.
3. Other Practitioners
Medical care practitioners, especially physicians, work with other practitioners in
three roles: as colleagues, supervisors, and competitors. These roles have become
more important as medical care delivery moves from the small private physician’s
offices to managed and team care settings. As supervisors, practitioners must comply
with same workplace laws and regulations as supervisors in non–medical care
businesses, while also dealing with the issues that are unique to medical care
delivery. These include the duty to consult with other practitioners when it is
necessary for a patient’s welfare, the duty to ensure that subordinates and other team
members deliver good medical care, and that state and federal law and regulations
are followed.
4. Physician-Owned Businesses
Historically, most states have limited the ability of physicians to work as employees
of hospitals or other businesses that are not controlled by physician owners. Until
recently, this meant that physicians tended to work as solo practitioners, in small
groups, or for physician-owned clinics. These businesses employ both physicians and
other personnel to aid in the practice of medicine. These persons are protected by the
usual business laws governing the employer–employee relationship. In addition, they
pose some special legal problems related to medical licensure, the supervision of
personnel, and antitrust considerations.
Physicians often employ nonphysician medical personnel, such as nurses, laboratory
technicians, physician’s assistants, and respiratory therapists. As employers, the
physicians assume both the general employers’ vicarious liability for the acts of its
employees, and the special duties of supervision of medical personnel that are
imposed by state and federal law. They must be concerned with the appropriate level
of delegation for medical care services provided in their offices. Physician–
employers must also recognize that while physicians are licensed to perform all
medical services, they are often not as skilled as the midlevel practitioners in many
routine procedures.
Finally, physicians must compete fairly with other physicians, resisting the
temptation to use quality-of-care issues as a cover for anticompetitive activities. This
has become a major area of legal conflict as medical practice has become more
competitive. The United States has traditionally valued free enterprise and has strict
laws governing attempts to restrict competition. Physicians must balance the need to
preserve good quality medical care against the policy of allowing the market to
regulate business activities.
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