Be Not Afraid of Change: Time to Eliminate the Corporate Practice of Medicine Doctrine

Abstract:     
This article argues that the corporate practice of medicine doctrine is a physician-centric, guild type doctrine that is misplaced in the present incarnation of the American healthcare system and that does nothing to improve quality, efficiency, or accountability. The paper focuses on three key reasons that the corporate practice of medicine doctrine should be laid to rest. First, the motives for creating the corporate practice of medicine doctrine are long gone, as physicians have not been able to operate as a guild of autonomous providers of healthcare for quite some time. Second, it is disingenuous to pretend that physicians are not influenced by financial gain, which is evidenced by the federal and state prohibitions against physician self-referral and by the exodus from Medicare and Medicaid that is the result of decreasing reimbursement. Third, the corporate practice of medicine doctrine does nothing to advance error-free, high quality healthcare and may stand in the way of improving the quality of healthcare. Recent reports by the Institute of Medicine demonstrate and emphasize this point. In order to overcome the many manifestations of the state-based corporate practice of medicine doctrine, this article proposes federal legislation to effectuate alignment.

Keywords: Corporate, medicine, health, physician, quality

JEL Classification: I00, I10, I11, I18, K2

Accepted Paper Series