Practice Management Q&As

When a partner won't take call

One member of our five doctor cardiology group has decided to stop taking call. He refuses to even discuss the matter. What's the best way to handle this?

If the other doctors in your group agree that his behavior is unacceptable, call for a vote to demand his resignation. That may mean taking a temporary financial hit when he leaves your group, but it's probably the best solution.

If a holiday falls on a Sunday

My office manager and I disagree about how to handle paid holidays when they fall on a Sunday, a day we're normally not open. I say we should pay our employees for Sunday and open on Monday as usual. She says we should close on Monday and pay them for that day. What do your experts recommend?

Listen to your office manager. A paid holiday should be just that-a day away from work for rejuvenation and enjoyment.

Wet-leasing equipment

I currently refer my patients for DEXA scans and ultrasounds to a radiology center in the building where I have my office. One of the radiologists there suggested I look into "wet-leasing" the machines instead. Could you please explain what this is and whether it's a good idea.

Wet-leasing is a contractual arrangement where you lease both the equipment and the technical staff who run the tests. (The terminology comes from the jet leasing business. "Wet" is a plane with the pilot; "dry" is just the plane). It allows you to bill for the technical component of the tests just as if you owned the equipment and your own staff provided the services.

In this situation-where you and the radiologist practice in the same building-wet-leasing probably means subletting specific time slots for the use of the equipment and staff under a shared facility arrangement.

If you plan to do this, make sure to consult an experienced healthcare attorney, not just a general small-business lawyer. He'll make sure your arrangement doesn't violate Stark and antikickback laws or your contractual arrangements with your health plans.

If the radiologist tells you his attorney has done all the leg work, and that he has several other primary care doctors in similar wet-lease arrangements, ask him for copies of all the documents and send them to your own healthcare attorney. You need a second opinion from someone looking out for your interests.

Releasing information to a patient's insurer

We've recently opened a wound care center at our hospital. A health insurer has requested a patient's wound picture. Do we need the patient's authorization to release this information?

No, not when you're releasing the information in order to get paid. HIPAA permits you to disclose protected health information for purposes of treatment, payment, or healthcare operations.