The Corporate Transformation of Medical Specialty Care: The Exemplary Case of Neonatology

• Published in: The Journal of law, medicine & ethics Vol. 36; no. 4; pp. 790 - 802
• Main Author: Kinney, Eleanor D.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2008; SAGE Publications; Sage Publications, Inc; Cambridge University Press
• Subjects: Agreements; Antitrust Laws - economics; Antitrust Laws - statistics & numerical data; Arbitration; Business models; Certification; Company legal issue; Covenants; Economics, Medical; Employees; Employment; Employment contracts; Ethics; Government regulation; Health care delivery; Health care industry; Health care policy; Health maintenance organizations; Health services; Health technology assessment; Hemodialysis; HMOs; Hospital systems; Hospitals; Humans; Laws, regulations and rules; Medical care; Medical care (Private); Medical technology; Medicine; Medicine - classification; Medicine - statistics & numerical data; Neonatology; Neonatology - economics; Neonatology - statistics & numerical data; Neonatology - trends; Non-competition agreements; Noncompete agreements; Patients; Physician practice management; Physicians; Provisions; Specialization; Third party; United States; Wealth; United States; United States > US; Indianapolis Indiana
• ISSN: 1073-1105; 1748-720X
• DOI: 10.1111/j.1748-720X.2008.00338.x

The key to wealth in health care is the physician, who certifies to third‐party payers that health care items and services are necessary for patient care. To compete more effectively for this wealth, physician specialists are organizing their practices into for‐profit corporations and employing other physicians. Focusing on neonatology, this article describes the prevailing business model of these for‐profit medical groups as controlling employed physicians through restrictive employment contract provisions, e.g., non‐compete and mandatory arbitration clauses. With this business model and because of deficiencies in current law, for‐profit medical groups eliminate competition from other physician specialists to the detriment of patients and consumers.