in the nation for physicians’ clinical autonomy and indepen- dent medical decision making.
“The long-standing ban on the corporate practice of medi- cine was again under attack this session, but TMA was able to preserve the Texas ban on corporate practice of medicine with several carefully controlled expansions for physician employ- ment,” said Dallas dermatologist Dan McCoy, MD, immediate past chair of the TMA Council on Legislation. “These include strong protections for clinical autonomy and independent medical judgment.”
Dallas County Medical Society and alliance members meet with a staff member for State Rep. Will Hartnett (R-Dallas). Pictured, left to right, are Caroline Evans, MD; Leslie Secrest; Rajiv Rugwani, MD; Steven Hays, MD; Sarah Helfand, MD; Debbie Fuller, MD; Dee Whittlesey, MD; Representative Harnett’s chief of staff Stephen Raines; Shelton Hopkins, MD; Lee Ann Pearse, MD; and Dr. Pearse’s husband, Einar Vagnes.
Over the past several sessions, a number of hospitals — mostly small rural facilities and urban county hospital districts — repeatedly sought legislation to allow them to directly em- ploy physicians. In 2009, lawmakers passed a compromise bill hammered out by TMA and TORCH to allow hos- pitals in coun- ties of fewer than 50,000 population, critical access hospitals, and
sole community hospitals to employ physicians. Gov. Rick Perry, however, vetoed that bill at TMA’s request because of an unrelated medical liability provision added to the measure at the last minute that would have weakened the 2003 Texas medical liability reforms. This year, a handful of small rural counties introduced bills to allow physician employment, without protections for phy- sicians’ clinical autonomy. Again, TMA agreed with TORCH and THA to allow employment by small hospitals, generally in counties of 50,000 or fewer, with strong protections for in- dependent medical judgment and medical staff responsibility for all clinical policies from privileges to credentialing to uti- lization review. Dan Finch, director of TMA’s Legislative Affairs Department, says this year’s compromise was built on the bill Governor Perry vetoed in 2009. But hospitals balked at a provision in the 2009 bill that required hospitals to seek a certificate from TMB to employ doctors. To overcome that issue, TMA, TORCH, and THA agreed to even stronger protections for physician autonomy this year. “We again drove the supervision of all clinical aspects of medicine to the hospital’s medical staff,” said Mr. Finch. “They are responsible for all policies related to peer review, utiliza- tion review, privileges, and credentialing. We guarantee inde-
28 TEXAS MEDICINE August 2011
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