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Highlights
The physician-patient relationship is a fiduciary relationship.
Managed care creates profound conflicts of interest between health care practitioners and patients.
The law of the physician-patient relationship does not change in managed care.
Most states require nonphysician practitioners to be supervised by physicians.
Physician medical directors face special legal risks.
Managed care poses new business risks to health care practitioners.
Introduction
The Changing Nature Of Physicians' Practices
Corporate Practice of Medicine
The Rise of MCOs
The Structure of MCOs
The Controlling Entity
Relationships with Physicians
Additional Contractual Terms
How Do They Reduce Costs?
Fiduciary Duty
Physicians as Fiduciaries
Training and Licensure
Market Factors
Duties of a Fiduciary
Legal Risks
Erisa Health Plans
ERISA Preemption
Hidden Incentives
Preemption of Claims
The Shea Case
Team Care Issues
Vicarious Liability
Method of Payment
Control
Scope of Employment
Intentional Acts
Hospital Employees
Delegation of Authority
Explicit Delegation of Authority
Implicit Delegation of Authority
Triage
Evaluation of Medical Tests
Supervising Npps
Scope of Practice
Documentation
Quality Assurance
Drug Laws
Protocols
Physician Protocols
Teaching Protocols
Physician's Orders
NPP Protocols: Strict Protocols
Sample Protocol
Diagnostic Criteria
Examination/Laboratory
Treatment
Follow-Up
Referral
Epidemiology
Notes
Supervising Medical Students And Residents
Patients' Rights
Faculty Physicians
Fraud
Medical Students, Residents, and Fellows
Residents and Fellows
Medical Students
Nursing and Other Students
The Reality of Teaching Programs
Importance of the Law
Working with a Teaching Program
Maintaining Supervision
The Physician-Student Relationship
Fraud
Medical Director's Liability
Dual Capacity Doctrine
Medical Licensing Issues
Business Risks In Dealing With Mcos
Deselection from the MCO
Shifting Insurance Risks
Capitation Agreements
Indemnification Agreements
Malpractice Insurance Considerations
Antitrust Issues in Managed Care
References
Suggested Readings
Managed Care
Teaching And Supervision
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