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FTC Announces Rule Banning Noncompetes
Great for us docs no?
FTC bans noncompetes.
- Thread starter Dr Mantis Toboggan
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Great for us docs no?
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Looks like it will apply to physicians 120 days after the rule is officially published except for those physicians whom are in a senior role. This may include medical directorship being excluded from this rule.FTC Announces Rule Banning Noncompetes
www.ftc.gov
Great for us docs no?
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Unusual to see gov't making things better instead of worse
Even incompetence can accidentally and occasionally yield results
Even incompetence can accidentally and occasionally yield results
Even if it doesn't apply to every single employed physician in the country (which it should), it certainly makes the smaller number of hospitals it might not apply to a heck of a lot less desirable relatively than they than they were before. Hopefully it will pressure everyone to align.
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Read that some business groups are already suing. Even if upheld, probably will be tied up in courts for a few years.
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Chamber of commerce is suing. So will many others. The AHA is unhappy (which tells you it is probably viewed by them as good for docs). The question is will this go into effect while the lawsuits are being figured out.
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No, doubtful they can enforce it until the litigation is over. Of course hospitals view it as "good for docs" because it's good for the hospitals. They don't want a cardiologist leaving a hospital and going across town taking all of his/her patients with him/her. Good for docs is really just good for hospitals.
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If they don't want them to leave, perhaps they should focus more on incentivizing them to stay instead of keeping them under the thumb of a noncompete, which can likely make it that you have to consider uprooting your whole life to escape a bad job.
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Why would they do that when they could offer lower wages and force docs to stay with them with non-competes? You and I understand the way to make a doc not leave -- by using a carrot instead of a stick. Administrators want to use the stick so they can keep the carrot for themselves.
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FTC already clarified they *exclusively* mean c-suite positions where compensation may be complex and elements of compensation are actively negotiated with non-competes being used as a counterweight. Without that high level negotiation, there is no exception. So just c-suite people, not directorship. Also, fun fact - it does NOT exempt high level senior roles, it is that it won't retroactively invalidate it for those people. Everyone else is retroactively invalidated. Nobody can have non-competes going forward in the future.
FTC already said this argument is nonsense and they specifically addressed this in their ruling that they feel hospitals, including non-profit hospitals, are one of the clearest places where this will see a benefit. They have some legalese argument that even if non-profit institutions are not directly audited by the FTC through their narrow direct oversight powers doesn't mean that they aren't under the greater purview of the FTC to regulate commerce as a whole.
Ironically both of these questions were asked by Jake Tapper two days ago and answered by the FTC chairwoman (and the second one is specifically written in the FTC's statement on this).
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Advocate Heath, the 4th largest health system in the US, informed its physicians today that its status as a 501c3 falls outside of the FTC’s jurisdiction, and it will continue to enforce the non-compete clause in every physician’s contract once the rule goes into effect.
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Okay I usually don't like to ask questions that I feel like I'm going to get chastised about not knowing the answer but I legitimately want to know in this scenario. How does this affect ED docs? I've always been under the impression I can work wherever whenever. I've worked multiple PRNs at the same time and switched jobs within 50 miles without any waiting. Maybe I'm just missing something.
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Depends on your contract. For example, many “academic” sites dont allow docs to work elsewhere while working for them.
U Arizona and Vanderbilt do this. You can not work elsewhere while you work for them. Some of my residents have signed contracts where they can not do any work of any sort without the permission of the hospital.
Say you are an ED doc and you want to open a med spa, you cant. Say someone wants you to consult on a medical device. You cant. Say you want to open an urgent care, you cant.. etc. Say you want to work shifts in another ED you cant….. without their permission.
Your contracts likely dont have this. Many do..
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They're wrong and the FTC has written policy (which, ironically my hospitals firewall blocks 🤔) stating that it has very clear and historically established control over 501c3's when they are making market-wide policies and that their inability to make non-profit *specific* policies does not invalidate their ability to make "everyone in the market" policies.
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How would they find out? Asking for a friend
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When you are in the boonies moonlighting in secret and have to transfer a bad trauma to your main hospital it gets awkward.
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also why would you sign a contract with that in it?
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Good!
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Because the second the other place starts doing credentialing, it's going to pop to your primary that some other group is setting up to bill in your name. They'll know before you even work a shift.
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Thats fair. However, you have to go through credentialing. When you do that they reach out to all the places you worked previously. I dont know if they do but it wouldnt be hard to have someone cross reference people going through credentialing elsewhere and your active staff?
There might be simpler ways but this isnt my field of expertise. In addition, many states will list all th hospitals you have privileges at so again not rocket science to figure it out.
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I think this is easy for people to say. Similar to “I would never work for a CMG”. Let’s say there is a great job and it is paying $50/hr more than job 2.. You arent gonna sign because of this? Thats total nonsense. Will some people avoid it.. sure.. but enough sign that they have that language in there.
If you want to get a job in Denver it is possible you have to work for USACS even if you think they are a putrid organization.
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Because they just finished residency, have kids now 3 years in to a local school system and a spouse that wants some stability… Oh, and they’re broke as a joke with massive student loan notes now due, and the home town place (that knows all of this) they are signing their life away to offered a really cool looking sign on bonus that will be SO MUCH HELP!
… only it’s not help since the IRS only gives you 60% of it… and when you realize you hate where you work, it’s too damn late because not only is the non compete there, but you also now owe the GROSS prorated amount of your bonus money back, which you don’t have, because you’re still really really really broke. Local systems prey on new grads this way. It’s really wrong and sick. There should be more education on this, but I can see how a financial advisor giving a noon conference lecture on how your health system is going to try to screw you wouldn’t be too kosher with the brass.
Primary care docs are the real focus when it comes to noncompetes. Local system A starts screwing you over? Talk to local system B, get them to pay back your bonus you owe from A, and take your 3,000 patients with you. Way too easy without a non-compete. This can’t be allowed to happen.
Here’s where I’ll go off the reservation a bit, since my rantmobile motor is running hot tonight. Here’s a little insider baseball peek in to something else that’s huge that many docs outside of primary care aren’t aware of, and my take on what I see as the true intention.
A growing trend is for office calls to now go directly to a centralized call center. ‘Oh, I’m sorry, Dr. Frustrated (who has a large panel but has always been able to accommodate) doesn’t have an opening for the next 17 1/2 years, but Dr Reallynicenewgrad has something tomorrow at 9. So Dr Newguy starts seeing work-ins, new patients, and building a panel, he’s great at what he does and ‘his’ patients really love him, but they now play the patient shuffle with him (because his schedule is ‘full’ as well) and now ‘his’ patients have no freaking clue who they’re seeing, or what that person’s qualifications are. It’s pretty stinking sweet when you’ve been an attending for over 10 years and your appointment card says ‘provider’.
Dr Frustrated moves on and after 2-3 years, newguy probably does the same. He may or may not come back after his noncompete, but it won’t matter all that much since patients never really built a long term bond with him anyway. In reality they just look at ‘providers’ as intake monkeys. It sucks there, so likely a lot of turnover and they know this, but it doesn’t matter. It’s probably a way to get cheaper ‘providers’ anyway.
Sorry about the rant, but I’m living it, and haven’t seen it brought to light yet. So… Here’s where y’all feel it in the fromunda. The call center, that is staffed with nurses (you know advice from a nurse is looked at as gold) is also *prossibly* a pretty sweet steer job for the ED. (when pool players used to go on the road to gamble the local steer man that put them in good action usually wanted at least a 20% ‘jelly roll.’ I doubt the nurses see any of this, though.)
This may? help to explain at least some of your ‘why the hell are you here’ business. Dr Frustrated’s office (or better yet, they say Dr Frustrated) sent me here for my migraine and 175 systolic. I might have run out of my Bystolic, but I’m not sure. It’s really all I wanted to know but THE NURSE (gold advice, bro) told me that she was worried and I to come here. Can we hurry this up, I’m supposed to work tonight and I don’t want to take a demerit. Oh yeah, here’s the card to my high deductible private insurance plan. I hope this isn’t going to be too much. It’s WRONG and makes me so damn mad.
Let a board meeting go down and suits hear that primary care is down 12%, ED is down 10% and ortho and neurosurg surgeries are both down 7% over this time last year because they ‘lost’ 5 of their best long time primary care docs (and their panels) to the system across town… facilitated by non-competes being illegal. They would look like they’re shi**ing peach seeds.
They won’t let non-competes go quietly. I wonder how much $$$,$$$,$$$ they had to pony up so the cute little ‘doesn’t apply to non-profits’ exclusion was written in to the decision.
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Exactly.
Also, no better way to treat your docs than declaring that you intend to try to enforce this even after the government has been clear that it applies to you…
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