AHA lobbying against FTC non-compete ban.

[ProRealDoc]

FTC extends comment period for proposed rule banning noncompetes by 30 days

Updated March 7 at 10:00 a.m. | Industry groups from multiple sectors of the economy including healthcare had requested more time to review the proposed rule's impacts.

www.fiercehealthcare.com

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[MirrorTodd]

Not surprising, non-compete are amazing leverage to hold over employees. Why would they give that up without a fight?

 

[Guillemot]

Healthcare systems continue to consolidate into monopolies/oligopolies and want to continue their anticompetitive compensation suppression techniques.

Right now they can basically tell doctors to go get fuxked if they don't obey whatever orders are dictated to them.

 

[anonperson]

FTC extends comment period for proposed rule banning noncompetes by 30 days

Updated March 7 at 10:00 a.m. | Industry groups from multiple sectors of the economy including healthcare had requested more time to review the proposed rule's impacts.

www.fiercehealthcare.com

Completely bogus.

They only have to look at California.

There is no non competes here and the health care market has not been upended because of this. Most physicians are not just job hopping on a whim. Only if a job gets unbearable because of crappy pay or work conditions do people leave.

Non competes are one last way a major organization can screw the little guy.

 

[coffeebythelake]

hospital systems are NOT your friend

they represent the interests of the business of medicine. the healthcare industry. the corporate suits that think of profits only. the MBAs that tell doctors how they should practice medicine.

a victory for the AHA is a victory for the hospital CEOs and executives making millions of dollars a year and whose bonuses are contigent on screwing over patients and physicians. And they have plenty of time and resources to lobby.

 

[kidthor]

Unfortunately there is no unified voice for physicians advocating against non-competes. They ASA hasn't said anything. The AMA issued a statement against the proposed FTC ban (which is shameful on the AMA). The only groups I know of to speak out against non-competes are ACEP and AAEM.

The AHA is an awful organization and I think they try to trick the public into thinking that "hospitals" represent the interests of healthcare workers while simultaneously ensuring we're all legally trapped.

 

[ambiturner]

Unfortunately there is no unified voice for physicians advocating against non-competes. They ASA hasn't said anything. The AMA issued a statement against the proposed FTC ban (which is shameful on the AMA). The only groups I know of to speak out against non-competes are ACEP and AAEM.

The AHA is an awful organization and I think they try to trick the public into thinking that "hospitals" represent the interests of healthcare workers while simultaneously ensuring we're all legally trapped.

Unfortunately a large number of physicians also want to keep non-competes around, many of whom have expressed as such on this forum. So I’m not expecting much pushback from us or from our lobbyists, many of whom employ other doctors or are on the payroll of companies (AMCs) who do.

I get it from the perspective of someone with a small practice who doesn’t want to potentially train their competition. My friend who did Mohs had to sign a noncompete at his fellowship, would that practice shut their fellowship down if every graduate could potentially start doing cases in their backyard?

As the number of physician owners dwindles I assume we’ll all start to get more unified in our voice. This is happening at my hospital currently as the surgeons/anesthesiologists are increasingly treated as a single workforce. But it’s going to be tough to beat hospital systems that are way more politically and economically influential than any physician group.

 

[TheLoneWolf]

Nothing would bother admin as much as surgeons/proceduralists taking their work and ancillary services to ASC's and out of their hospitals. They have the admin, the lobbies, and pretty much everything in their favor in the current system. The easiest counterbalance would be to give physicians the ability to unionize.

 

[anonperson]

Unfortunately a large number of physicians also want to keep non-competes around, many of whom have expressed as such on this forum. So I’m not expecting much pushback from us or from our lobbyists, many of whom employ other doctors or are on the payroll of companies (AMCs) who do.

I get it from the perspective of someone with a small practice who doesn’t want to potentially train their competition. My friend who did Mohs had to sign a noncompete at his fellowship, would that practice shut their fellowship down if every graduate could potentially start doing cases in their backyard?

As the number of physician owners dwindles I assume we’ll all start to get more unified in our voice. This is happening at my hospital currently as the surgeons/anesthesiologists are increasingly treated as a single workforce. But it’s going to be tough to beat hospital systems that are way more politically and economically influential than any physician group.

If the Mohs fellowship director is so concerned about competition, then they should stop training other Mohs surgeons.

Anyone could open up shop in their backyard.

The sky has not fallen in states where non competes are not allowed.

 

[kidthor]

Yeah - if the employers have a good work environment with decent pay and benefits then people will stick around. The AHA / toxic employer argument is that to "compete" they need to prevent any and all local competition. Twisted logic at best.

 

[ambiturner]

If the Mohs fellowship director is so concerned about competition, then they should stop training other Mohs surgeons.

Anyone could open up shop in their backyard.

The sky has not fallen in states where non competes are not allowed.

I agree that, in a free market, and in anesthesia for that matter, the non competes aren’t needed. However, derm and mohs in particular are clearly fields that have used artificial scarcity of providers to their financial advantage especially in small markets (not California). The work is not so challenging or specialized as to necessitate limiting training spots to the extent that they do. Thus their incomes depend to a degree on protectionism and explains why you have to wait weeks to see a dermatologist and they will tell you to pound sand if you have bad insurance.

 

[linkin06]

Open for public comments. I gave them a small blurb on how working for private equity-backed corporations can severely restrict my job options. This is the best way for us to actually make a potential lobbying effort without the big bucks.

Regulations.gov

www.regulations.gov

 

[ambiturner]

From the ASA Monday email today. No surprise that they’re not slam dunk in the employees corner:

We seek to better understand the potential impact of the proposed rule on our members, so we would appreciate hearing from you about your experiences with non-compete agreements. Given our members’ various roles as employees and, in some practices as employers, we expect a diversity of opinion.

 

[linkin06]

From the ASA Monday email today. No surprise that they’re not slam dunk in the employees corner:

We seek to better understand the potential impact of the proposed rule on our members, so we would appreciate hearing from you about your experiences with non-compete agreements. Given our members’ various roles as employees and, in some practices as employers, we expect a diversity of opinion.

Wow definitely never donating again

 

[sbmed100]

It's reasonable to have a non-compete to prevent someone in your practice from stealing the business under the group at your existing site(s). It's the distance non-competes (i.e. 30 miles) that most people have difficulty defending. That gets in the way of market wage efficiency and causes lots of grief...

 

[TexBlazer2106]

Did anyone catch this but, “Chief among those considerations is that the FTC has no authority to apply its proposed rule to nonprofit hospitals and health systems, meaning that only for-profit hospitals would be subject to the increased regulatory burden”

So any proposed ban wouldn’t include non-profit entities if I’m reading it correctly.

 

[coffeebythelake]

Nonprofit status for hospitals is a huge scam. Lots of money moving around and into the pockets of the c suite regardless.

 

[kidthor]

It's reasonable to have a non-compete to prevent someone in your practice from stealing the business under the group at your existing site(s). It's the distance non-competes (i.e. 30 miles) that most people have difficulty defending. That gets in the way of market wage efficiency and causes lots of grief...

No. To prevent this issue you can just have a non-solicitation or non-poaching agreement for that group's exclusive sites only. Which is different from a non-compete agreement as (proposed to be) banned by the FTC.

 

[kidthor]

Did anyone catch this but, “Chief among those considerations is that the FTC has no authority to apply its proposed rule to nonprofit hospitals and health systems, meaning that only for-profit hospitals would be subject to the increased regulatory burden”

So any proposed ban wouldn’t include non-profit entities if I’m reading it correctly.

This argument is a red herring. The FTC regularly regulates non-profit behavior including hospitals, all the time. The AHA and associated groups are using this as a rhetorical trick to prelude their likely legal challenges to the FTC ban.

Here's a list of recent FTC actions including actions on plenty of nonprofit hospitals.

 

[HemeOncHopeful19]

No. To prevent this issue you can just have a non-solicitation or non-poaching agreement for that group's exclusive sites only. Which is different from a non-compete agreement as (proposed to be) banned by the FTC.

I’d be curious to hear from people that use non-solicitation agreements how they work in practice.

Patients not allowed to choose to follow the doc? Can doc advertise on a website or local billboard or does that count as “solicitation” of patients?

 

[kidthor]

I’d be curious to hear from people that use non-solicitation agreements how they work in practice.

Patients not allowed to choose to follow the doc? Can doc advertise on a website or local billboard or does that count as “solicitation” of patients?

As a random example Vanderbilt's is online here. Of interest they also have a separate non-compete clause in that document.

The non-solicitation means you can't solicit (e.g. billboard, verbal, email, phone contact, etc) patients or business interests. You can't restrict a patient from choosing to follow a doctor unsolicited though.

 

[secretasianman]

Wow definitely never donating again

They don’t want to piss off their bigger donors like the envisions. Fuc them.

 

[Dr. Rude]

Wow definitely never donating again

Remember, ASA represents employers of anesthesiologists. Not anesthesiologists. If I were a partner in a private practice, I would NOT be in favor of the non-competes that I held with my employees and the hospital going away. It is possibly the only corporate asset worth Anything.

 

[coffeebythelake]

Same reason why ASA always tries to play nice with AANA despite all the vitriol they've directed against physicians.

 

[TexBlazer2106]

This argument is a red herring. The FTC regularly regulates non-profit behavior including hospitals, all the time. The AHA and associated groups are using this as a rhetorical trick to prelude their likely legal challenges to the FTC ban.

Here's a list of recent FTC actions including actions on plenty of nonprofit hospitals.

Thank you

 

[linkin06]

 

[sbmed100]

Remember, ASA represents employers of anesthesiologists. Not anesthesiologists. If I were a partner in a private practice, I would NOT be in favor of the non-competes that I held with my employees and the hospital going away. It is possibly the only corporate asset worth Anything.

Right. So for everyone here that is so pro private-practice, the noncompete or nonsolicitation is very valuable for private practice groups. Without that anyone in the group could compete against the group itself by going to the hospital/ASC/office and undercutting his/her group.

 

[Dr. Rude]

Right. So for everyone here that is so pro private-practice, the noncompete or nonsolicitation is very valuable for private practice groups. Without that anyone in the group could compete against the group itself by going to the hospital/ASC/office and undercutting his/her group.

Agree. Assuming you are or expect to be a full partner at some point. Not an employee. Not a sub-partner.

I suspect, but don't know that today more than 50% of Anesthesiologists are employees or sub partners. Not real owners. Based on that assumption, ASA should be advocating for elimination of non-competes as it is in the best interest of a majority of the membership.

 

[MirrorTodd]

Right. So for everyone here that is so pro private-practice, the noncompete or nonsolicitation is very valuable for private practice groups. Without that anyone in the group could compete against the group itself by going to the hospital/ASC/office and undercutting his/her group.

And how likely is that possibility? Like for real man...do people in PP groups REALLY think they individual anesthesiologists are going to **** with the place that they work? Like it's really gonna be an epidemic of the free market where everyone is undercutting each other?

 

[Dr. Rude]

And how likely is that possibility? Like for real man...do people in PP groups REALLY think they individual anesthesiologists are going to **** with the place that they work? Like it's really gonna be an epidemic of the free market where everyone is undercutting each other?

While the scenario you presented is not likely, it is not impossible. I was thinking more of the hospital trying to hire the CRNAs from under the docs.

 

[MirrorTodd]

While the scenario you presented is not likely, it is not impossible. I was thinking more of the hospital trying to hire the CRNAs from under the docs.

That's possible too, but then who is breaking the crna's out at 3 when they are ready to go home? Sure as **** ain't me.

EDIT: I know that's all big talk, but I'm just playing reverse? devil's advocate.

 

[kidthor]

Agree. Assuming you are or expect to be a full partner at some point. Not an employee. Not a sub-partner.

I suspect, but don't know that today more than 50% of Anesthesiologists are employees or sub partners. Not real owners. Based on that assumption, ASA should be advocating for elimination of non-competes as it is in the best interest of a majority of the membership.

Not all managers and partners want a noncompete either. Plenty of them just offer a good work package and people want to stick around. Also plenty are in states that have banned noncompete (CA for example). The contingent of individual anesthesiologists who actually want noncompetes to continue are very few.

 

[sbmed100]

And how likely is that possibility? Like for real man...do people in PP groups REALLY think they individual anesthesiologists are going to **** with the place that they work? Like it's really gonna be an epidemic of the free market where everyone is undercutting each other?

Every PP group has its group dynamics, fractures and cliques. I agree it’s unlikely an individual would try this tactic but the market is full of stories of smaller parts of a larger private practice group splintering off and coming after the larger entity.

 

[Dr. Rude]

Every PP group has its group dynamics, fractures and cliques. I agree it’s unlikely an individual would try this tactic but the market is full of stories of smaller parts of a larger private practice group splintering off and coming after the larger entity.

Or just trying to skim off some cream, e.g., separate cardiac group, take the contract for a surgicenter that the group covers.