Practice Management Q&As

April 8, 2005

Help, or fraud?; partnership; rental liability; deductions for employed doctors.

Is this fraud, or helping a patient? Q. My partner treats a chronically ill patient who recently reached the limit on her healthcare coverage. Because this patient is facing financial hardship, my partner is now billing for her care under her daughter's name. I know this is fraud, but I feel for the patient, so I've turned a blind eye to it. Could I be held liable for my partner's actions if the insurer discovers the fraud?

A. Yes. You could both face heavy fines, loss of managed care contracts, and disciplinary action by your state medical board. If your partner wants to help this patient, he should consider reducing or waiving his charges. Or he should direct the patient to the social service agency in your state that coordinates coverage for low-income or chronically ill patients.

If an employer won't discuss partnershipQ. Of the five groups I've interviewed with, the one I'm most interested in joining-a four-doctor primary care practice-has the peculiar policy of requiring an associate to work for six months before discussing a buy-in contract. Should I jump on board anyway?

A slip-and-fall outside your officeQ. Because my landlord failed to fix a broken downspout near my practice's front door, a patient slipped and fell on an ice patch. Now the patient, who broke his leg, has threatened to sue me. But shouldn't it be the property owner who's liable?

A. He may be ultimately liable, depending on your lease agreement. If premises liability isn't covered in your contract with the landlord, determining responsibility for damages may come down to your state's law or a city ordinance. Many cities require commercial tenants to keep their walkways free of hazards.

When a patient bashes an HMOQ. How should I respond to a patient who complains about his managed care plan during an exam?

A. Tell the patient that you have no control over the insurer's policies and procedures. Encourage him to contact both his employer and the plan about the problems. If your contract with the plan has a gag order, you're prohibited from discussing the plan's policies with patients. In that case, tell the patient you can't comment-and why.

Tax deductions for employed doctorsQ. As a salaried physician, I've been incurring expenses for supplies that I need but that the group's office manager says aren't in the budget. The items include some clinical supplies, including a pulse oximeter, as well as furniture for my office and dry-cleaning my white jackets. If these expenses exceed 2 percent of my income, can I write them off on my tax return?

A. Not the first 2 percent, but you can deduct everything above that. Make sure you get documentation from your employer to support these deductions.

Do you have a practice management question that may be stumping other doctors, too? Write PMQA Editor, Medical Economics, 5 Paragon Drive, Montvale, NJ 07645-1742, or send an e-mail to mepractice@advanstar.com (please include your regular postal address). Sorry, but we're not able to answer readers individually.