155.000 INDEPENDENT PRACTICE OF MEDICINE

155.989           Supporting Independent Practice- Payment Parity

The Medical Society of the State of New York will advocate for payment parity for physicians providing the same services (adjusted for local costs), allowing small independent practices to survive, thus helping to stem the loss of physicians to locum tenens, concierge practice and non-clinical careers, and helping to preserve the continuity, accessibility, availability, and affordability of care. (HOD 2024 – 259)

155.990           Role of Private Equity in Medicine and Acquisition of Medical Practices

MSSNY will continue to work with the American Medical Association (AMA) to help educate physicians regarding the risks and considerations associated with practice affiliation with corporate or private equity investment, consistent with materials developed by the AMA to educate physicians for that purpose.

MSSNY will continue to strongly advocate for protections against corporate interference in physician decision-making which affects the care and treatment of patients and will advocate to protect continuity of care for patients which includes access to care by their physicians in the event of contract transitions, bankruptcy, or other adverse events that may arise from practice affiliation with corporate or private equity investment. (HOD 2020-100 and 2020-105, referred to Council, adopted 6/3/21)

155.991                       Restrictive Covenants

The Medical Society of the State of New York will support legislation that prohibits a “restrictive covenant” provision in a health system-physician employment contract or in a contract between a Management Services Organization (MSO) and a physician that limits the ability of such physician to deliver care in the same region after the physician leaves employment from such health system or leaves the medical practice that utilizes that MSO.

The Medical Society of the State of New York will conduct a survey of physicians to assess their support or opposition to legislation to prohibit all restrictive covenants. (HOD 2020-54 and 55, referred to Council, adopted 11/5/20, reaffirmed Council 1/26/23)

155.992        Improving Independent Practice Opportunities for Physicians

MSSNY will partner with the American Medical Association, other interested national medical state and specialty societies, and other appropriate bodies to further study the challenges that discourage physicians from pursuing independent practice.

MSSNY will partner with the AMA, other interested national medical state and specialty societies and other appropriate bodies to provide physicians interested in independent practice access to resources that would make independent practice more tenable for a physician.  (HOD 2020 -204) 

155.993        Report on the Preservation of Independent Medical Practice

MSSNY will issue a report every two years on its activities to preserve independent medical practice and will request that AMA issue a report communicating their efforts every two years as well. (HOD 2020-207)

155.994        Physician Owned Distributorships

The Medical Society of the State of New York supports the concept of Physician Owned Distributorships (PODs), provided that they are operated consistently with generally accepted principles of physician ethical conduct (such as the AMA Code of Medical Ethics), including ensuring that patients and other potential contractors are sufficiently notified of the physician’s financial interest in such POD.  (HOD 2019-122, referred to Council. Amended and adopted 11/2019)

155.995        Healthcare Cooperative Act

The Medical Society of the State of New York will seek legislation to create a physician-led healthcare cooperative in New York as one pathway for achieving legally permissible state supervised collective negotiation rights for physicians.  (HOD 2019-72, referred to Council. Amended and adopted 11/2019)

155.996        Unionization of Independent Physicians

The Medical Society of the State of New York (MSSNY) with legal counsel will explore the following:

-the legal ability to and cost associated with physicians unionizing, under the legal theory that physicians have de facto become part-time employees of insurance companies;

-whether any established unions that represent employed physicians will support efforts to unionize physicians in independent practice;

-ways to enhance integration of independently practicing physicians through all legal means including IPAs and ACOs in order to enhance their leverage in negotiations with managed care plans and health insurers;

The Medical Society of the State of New York will initiate its exploration of the legal ability and cost associated with unionizing physicians in independent practice, whether any unions will support efforts to unionize physicians in independent practice and enhance integration of independently practicing physicians before the 2017 meeting of the MSSNY House of Delegates. (HOD 2016-103)

155.997                        Survival of Independent Practice

The Medical Society of the State of New York will set up a task force to explore all legally permissible options for independent physicians to collaborate and create practice models to achieve the goals of diversity of service, economy of scale, and collective negotiations.

This task force will consult with all necessary parties and examine models that have been used in other states in order to obtain the information necessary to conduct its assigned task; and the task force will report its findings to the Council of the Medical Society of the State of New York within six months of the ending of the 2015 meeting of the House of Delegates. The Council of the Medical Society of the State of New York will then develop a plan of action to preserve independent practice in New York State. (HOD 2015-210)

155.998                         Support For “Concierge” Practices

The Medical Society of the State of New York supports the concept that a physician should be free to define a business model to practice medicine in New York that is most appropriate to that physician and his/her patients. (HOD 2012-58; Reaffirmed HOD 2022)

155.999                          Independent Practice of Medicine by Nurse Practitioners:

MSSNY, in the public interest, opposes the independent practice of medicine by any individuals who have not completed the presently prescribed education and the examination for licensure for the practice of medicine and, furthermore, has taken the position that the independent practice of medicine remain under the authority and control of the Board of Regents as assisted by the New York State Board for Medicine.

(HOD 1982-1; Reaffirmed HOD 2013; Reaffirmed HOD 2023)