It was hot in San Antonio…but we aren’t talking about the temperature! The NAPR 2006 Annual Convention was held April 19-21, 2006, at the Hilton Palacio del Rio in historic San Antonio. Over 250 attendees not only received the highest-quality educational programs available but were also presented with an opportunity to experience Texas hospitality at its finest. From the top-notch speakers and topics to the social and networking hours to an off-site authentic Texas B-B-Q, the resounding echoes of the meeting were nothing short of fantastic. Some of the highlights of the annual meeting include the presentation of the much-anticipated NAPR awards as well as the introduction of the 2006-2007 NAPR Board of Directors:

Karen Zeller Assumes Role as NAPR President
Karen Zeller was installed as the 2006-2007 President of the National Association of Physician Recruiters during the ceremony on Thursday, April 20, 2006. Zeller has served on the NAPR Board for the past several years and has also chaired the 2006 Annual Convention in San Antonio as well as served on several NAPR committees. Most recently, Zeller served as President-Elect as well as NAPR Vice President. In addition, she has served as President of NAPR in 2003-2004. Zeller assumed her duties immediately following the NAPR 22nd Annual Business meeting.

Toldt Elected President-Elect
Members of the newly elected NAPR Board of Directors at their initial meeting on Thursday, April 20, elected Jo-Ann Toldt as NAPR President-Elect. In addition to serving on the Board for the past several years, Toldt served on several NAPR committees, including Chair of the Membership Commmittee, Annual Convention Committee, and Website Committee. Toldt assumed her duties immediately following the NAPR Board meeting on April 20, 2006.

NEW DIRECTORS WELCOMED
The following Directors were welcomed on the 2006-2007 NAPR Board of Directors: Susie Brown, D&Y, and Pat Doyle-Grace, Cejka Search.

AWARDS PRESENTED
Distinguished Service Award: Michael Broxterman was presented the NAPR Distinguished Service Award, the highest award given by NAPR, for his devotion to and leadership of NAPR. This inherent trait that we share ? the drive to strive for perfection ? is one of the main reasons our Association continues to prosper. The recipient of the Distinguished Service Award personifies the traits just described. Mike is committed to NAPR and has been committed to the organization since the mid-1990s. He is dedicated to the art and science of physician recruiting. He has served on many committees in the NAPR and led us as President in 2004-2005. He has given his time, his expertise, and his business secrets as his outstanding contributions to the organization.

President’s Award: Marty Osinski was presented the President’s Award for unselfishly giving of his time, knowledge and creativity to support NAPR and its mission. Osinski has a long-standing history with his involvement with NAPR. As the current Secretary/Treasurer for the organization, his past roles and responsibilities have included serving as NAPR President in 1992; serving as Chair of the Convention Committee multiples times, as well as participating on the Arbitration and Ethics Committees. It is this type of dedication to NAPR that has enabled him to be awarded with the President’s Award twice in the past 15 years.

Vendor Appreciation Award: The NAPR Board of Directors voted to present the 2006 Vendor Appreciation Award to PhysicianWork.com. This organization has supported NAPR year in and year out through sponsorships, exhibits at the meetings, as well as advertising in several NAPR publications. The award was accepted by Jeff Sisk, PhysicianWork.com, at the Exhibitor Lunch on Friday, April 21, 2006.

Outstanding Committee Chair Award: The recipient of this award, Wanda Parker, has worked tirelessly in the background ensuring that the NAPR website is safe, secure, and productive for all NAPR members. She has devoted untold hours to “sleuthing” the “questionable” accesses to our World Job Bank and has made hundreds of phone calls to verify that users are who they say they are. In laymen’s terms, she is a 24-hour security guard…and she has never sought recognition or accolades for her efforts.

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Vendor Profile

American Medical Association
By NAPR Headquarters Staff

1.  What does this company do?
Since 1847, the American Medical Association (AMA) has worked to ensure the continued quality and improvement of undergraduate (medical school), graduate (residency/fellowship), and continuing medical education. Our Division of Graduate Medical Education offers information and data to help physician recruiters learn about and get in touch with residency/fellowship program directors and resident/fellows.

2.  What is your position there?
I am Director of Medical Education Products, which is part of the Division of GME.

3.  What services or products do you provide that would be of interest to physician recruiters?

• Graduate Medical Education Program Electronic Data (GMEPED)—Provides contact information (including address, phone, and fax) for nearly 8,400 ACGME-accredited and combined specialty residency/fellowship programs throughout the country. Data available by specialty and/or state, in Microsoft Excel, for 1-year licensing agreement.
• Graduate Medical Education Directory (“Green Book”)—Includes contact information for nearly 8,400 GME programs and teaching institutions, as well as descriptions of and data for specialties/subspecialties, medical specialty board certification requirements, a list of US medical schools, medical licensure information, a list of GME programs in Canada, and a GME glossary. The GME Library on CD-ROM offers same information in searchable CD-ROM format.
• State Medical Licensure Requirements and Statistics—Keep up-to-date on changes in state licensure statutes; offers key state-by-state statistics on licensing requirements, fees, license renewal, and GME/CME requirements.
• GME E-letter—Stay informed on the latest issues/trends in GME by subscribing to this free monthly e-mail newsletter, covering everything from resident work hours to accreditation updates and physician workforce.
• Health Professions Career and Education Directory—Lists 6,666 educational programs and 2,800 educational institutions in 67 different allied health professions, from radiographer and medical assistant to art therapist, physician assistant, and rehabilitation counselor.
  

4.  Please provide a brief profile about yourself.
Fred Donini-Lenhoff has worked in the Medical Education Group since 1995. Prior to that he worked for 2 years with the AMA Alliance, which represents spouses of physicians, so he knows how important it is to keep that constituency happy, whether recruiting physicians or anything else. Fred has a MA degree (English) from DePaul and a BA degree (also English) from Florida State University. A reverse snowbird (sunbird?), he moved from Florida to Chicago in 1985 because he wanted a challenge.

Contact information
Fred Donini-Lenhoff
312-464-4635
For more information on the products listed above, see: http://www.ama-assn.org/go/mededproducts. To view the current issue of the GME E-letter, see: http://www.ama-assn.org/go/gmenews.

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Ask Miss Deed...


Dear Miss Deed:
In order for my physician candidate to receive credentialing for my client hospital the hospital requires case logs for at least 100 procedures for the last 2 years. The hospital is not asking for names, just procedure/date/time. The candidate has already signed a contract with this hospital, but she has told the hospital that it is against HIPPA privacy regulations to provide them with the requested information. Unless the candidate provides the procedure list, she will not be credentialed and hired by the hospital. The hospital has stated they require this information to credential any candidate and have had no previous problems obtaining this information. Can you provide any enlightenment on this subject?

Exasperated

Dear Exasperated:
Your question is not a subject matter I usually deal with and I had to do some research. We spoke with Keisha Edwards, Investigator for the Office of Civil Rights of the Department of Health and Human Services. The Office of Civil Rights deals with HIPPA complaints and answers specific HIPPA questions. For credentialing purposes, according to Ms. Edwards, it is NOT a HIPPA violation for a physician to provide a list of procedures which has NO patient specific information on it. Both hospital and physician are HIPPA providers and may share certain information under HIPPA guidelines. The list should NOT include time of day (this could potentially be traced back to a particular patient).

Your candidate can contact the Office of Civil Rights directly, should she have other specific questions: 800-368-1019; www.hhs.gov/ocr/hippa.

HIPPA is regulated by The U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201,

The entire HIPPA statute may be viewed at the following link http://aspe.hhs.gov/admnsimp/pl104191.htm

Cordially,
Miss Deed

Miss Deed is an expert on all things ethical, and is ready to answer your questions. All questions to Miss Deed must be accompanied by the individual's name, telephone, and e-mail address. If the individual does not want his or her name published, we will publish the question with the statement: "Name Withheld by Request." No questions will be considered without verifying who the sender is. Send your questions to Miss Deed at the following e-mail address: DearMissDeed@napr.org and your question may appear in an upcoming NewsFlash!

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Are Non-Compete Clauses Illegal? Several Jurisdictions Say Yes!

If the courts holdings in selected states regarding non-competes are adopted by other jurisdictions, the physician recruitment industry could be impacted.

Courts in Pennsylvania and Tennessee have held that the public’s interest in specialty care was superior to the business interest of a hospital system.

In Wellspan Health v. Bagless (2005), a physician joined the above captioned health system as an employee. In the physician’s employment agreement, restrictive covenant provisions prevented him from practicing in four contiguous counties for two years after his employment for any reason. The physician resigned from the health system and immediately started a private practice. The health system obtained a court order prohibiting the physician from practicing in two of the hour counties stated in his non-compete clause. The health system appealed to the Superior Court which held against the health system.

The Superior Court based its decision on legal precedents in the Pennsylvania courts that have held non-compete clauses are, “unreasonable restraints on competition”. The burden of proof is placed on the person seeking to enforce a non-compete provision in the state of Pennsylvania. The standard used by Pennsylvania Courts states, “A party seeking to enforce a non-compete clause, must show that its’ enforcement is reasonably related to the protection of a legitimate business interest.” The courts held that Wellspan had to have a “legally protectable interest” before its non-compete clause could be upheld. The courts held that under Pennsylvania law, a patient base is a legally protectable interest under non-compete agreements. The courts also compared a medical care referral base to a physician’s relationship with his/her patients, both of which were held to be “protectable interests”. The courts in the Wellspan case noted the impact on the community enforcing the non-compete would have on depriving the community of the specialty care provided by the physician whose case was before the court. The court held that the interest of the patient was paramount. The Wellspan holding will have a precedential impact in other jurisdictions, specifically those deemed “underserved.”

Other states such as Tennessee and California have ruled against restrictive covenants for similar public policy reasons as held in the Wellspan case. The Supreme Court in medical clinic (P.A. v. David Udom). The courts held patients had a right of freedom of choice in choosing a physician and have a right to continue an ongoing relationship with their physician.

Non-compete clauses are generally illegal in California. Many businesses are not aware of this fact. The California business and professionals code 16600 states that “every contract by which anyone is restrained from engaging in a lawful profession, trade or business of any kind is to that extent void”. The California statue does allow for some exceptions as handed down in (Morris v. Harris, 1954 127 cal. app. 476) and (Diodes, Inc v. Franzen (1968) 260 cal. app. 2d 244). The holdings in these cases prevent former employees from accepting work from any of the employer’s clients. The business and professions code 16601 also has an “exception permitting lawful non-compete agreements for company owners.” The state of Georgia also had some litigation pertaining to non-compete clauses.

The Tennessee Appeals Court also held that restrictive covenants are illegal. The courts held in (Murfreesboro Medical Clinic, P.A. v. David Udom) that “due to public policy considerations implicated by physician’s covenants not to compete along with the ethical problems raised by them, and state legislatures decision not to statutorily validate all such covenants,” are inimical to public policy and unenforceable. The state legislatures in Tennessee followed precedents of the American Medical Association (AMA). The AMA stated non-compete provisions were contrary to AMA standards which view non-competes as violative of AMA ethical standards because they “restrict competition”, disrupt continuity of care and potentially deprive the public of medical services. The courts in Tennessee held non-competes unenforceable against physicians with some exceptions.

We can see a definite trend nationwide in the courts’ rulings that non-competes are unlawful. It is anticipated that other states will adopt the laws that have been mandated by the courts in this article. The recruitment industry could be impacted by this legal trend. I interviewed an attorney in the state of Tennessee for this article. I questioned him regarding the case making non-compete clauses illegal. The attorney stated he felt the ruling in the case was unique to the facts in that case. He further stated his belief that making non-competes illegal would not result in other jurisdictions following the courts decision in Tennessee. I respectfully disagree. The holdings cited in this article is evidence of a trend that I believe will continue. If this trend does continue, medical groups will be forced to protect their business interest in ways that could impede the recruitment of new physicians. For example, groups may bring new physicians in as independent contractors. Such arrangements would not be favorable to newly recruited physicians. First, their legal exposure could be greater. Next, they could be impacted financially.

Agreements between a medical group and a physician contracted with on an independent basis would not have a non-compete provision. These types of agreements would most likely have a “non use - non disclosure” clause. These types of agreement would not prohibit the physician from practicing within a certain geographic parameter for a specified period of time. These agreements would prohibit the Independent Contractor physician from taking the groups patients and or other confidential information. This type of contractual relationship could complicate the negotiation process which might foster the excessive use of legal counsel which could impact our industry. Finally, physicians who are seeking practice opportunities may restrict themselves regarding the types of practices they pursue.

We can only speculate as to what the impact will be. We can though to a reasonable certainty anticipate that our industry will be impacted. Only time will determine if the legal trend discussed in this article will have a negative impact on the recruitment industry.

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Conrad 30 J-1 Waiver Program Begins June 1, 2006

The Conrad 30 J-1 waiver program for physicians is set to begin to sunset on June 1st. Bills have been introduced in both Houses of Congress to permanently authorize the program and a provision to extend has also been included in the major immigration legislation that has been the subject of so much news coverage in recent months. However, passage of any of these bills is far from certain.

Proponents of the legislation are also pushing for additional changes to physician immigration rules including exempting all H-1B doctors from visa quotas if they serve in underserved areas, green card cap exemptions for medical doctors and more waivers for large states like Texas and Florida.

The US House of Representatives is set to have hearings soon regarding extension of the Conrad 30 program. One of the witnesses will be a representative of the General Accounting Office who will discuss the findings of a soon-to-be released report on the program. The GAO report is expected to paint a positive picture of the Conrad program, though it will express concern that there has been a pronounced shift of doctors from entering on J-1s to coming on H-1Bs. That is resulting in fewer doctors working in medically underserved areas.

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What Can Joint Commission Health Care Staffing Services Certification Do for You?

Gain a competitive edge by obtaining Joint Commission Health Care Staffing Services certification. Increase your firm's credibility, improve your risk management and risk reduction practices while utilizing a management framework focused on qualify, safety and improving performance.

Joint Commission Resources' Health Care Staffing Services Certification Workshop is an opportunity for owners, business managers, compliance officers and other health care staffing firm personnel to learn more about this new certification program. You'll learn about the review process, complete with sample agendas, the types of documents needed during review, and strategies for standards compliance. Topics also include performance improvement and measurement, data collection and reporting. A question and answer period will follow the workshop. Dates and Locations: November 30, 2006, Scottsdale, AZ. Fee: $375 per person. To register for this program or for more information, please call Customer Service toll free at 877-223-6866, or click here to register.