Some physician practice management firms are attempting to form a trade group just as confidence in the PPM industry has ebbed.
Executives of 13 companies attended an initial meeting last month in Washington, said Kevin Outterson, a partner at Memphis, Tenn.-based Baker, Donelson, Bearman & Caldwell, one of two law firms that sponsored the event.
Participants hope to establish a formal organization and hire an executive director by Jan. 1, Outterson said.
Organizers claim a host of legal and business issues are not addressed by existing physician lobbying groups, such as the American Medical Association and the American Medical Group Association. Issues include antitrust, corporate practice of medicine, risk-contracting regulations and employee benefits, they say.
A strong lobby could counter negative publicity surrounding the industry, some of it from doctors who are unhappy with management contracts, said Ira Coleman, managing partner in the Miami office of McDermott, Will & Emery, which co-sponsored the initial meeting. The firm represents at least 30 PPM companies.
Coleman said that without such a balance, policymakers "are going to hear the horror stories from all the doctors who know the congressmen and senators, and legislation is going to be affected by emotion rather than facts."
At the top of the coalition's agenda is overturning an advisory opinion released earlier this year by HHS' inspector general's office. That opinion brought into question the legality of doctors' paying management companies for marketing-related services (April 27, p. 13).
The group hopes to obtain a new advisory opinion from the agency or seek declaratory statements from state medical boards in order to affirm the legality of those arrangements, said Jerry Sokol, another lawyer with MerDermott, Will & Emery.
Yet it will be a challenge to bring a unified voice to the young, fragmented industry. PPMs have a variety of strategies and specialties, not to mention management styles.
The companies also are operating in a harsh financial climate, with many simply trying to stay afloat.
"Whether the idea becomes reality, I'm not sure," said Mitchell Eisenberg, M.D., president and chief executive officer of Hollywood, Fla.-based Sheridan Healthcare, which manages 245 hospital-based doctors.
Eisenberg had hoped for greater attendance at the initial meeting, given that there are more than 100 private and public PPM firms nationwide. He speculated that firms are busy "trying to keep their house in order."
Participants included Birmingham, Ala.-based MedPartners, Houston-based American Oncology Resources and Memphis-based Omega Health Systems. Before the meeting, MedPartners President and CEO E. Mac Crawford sent letters asking executives to attend, a spokesman for MedPartners said.
Notably absent was Nashville-based PhyCor. Outterson said that as of last week, the nation's leading multispecialty PPM had not responded to a request to participate.