3 Learnings from Services Agreements for University based General Practitioners
As a medical practice business owner or leader, it is always interesting to take learnings from other industries that are aligned with what you do in your own business. As lawyers for medical practices, we have recently been engaged by a few different university in-house lawyers to update their Services Agreement for the General Practitioners (GPs) engaged to see on-campus students and staff. In the evolving landscape of healthcare provision, Universities are increasingly relying on Service Agreements with GPs, and these arrangements have proven to be beneficial for both universities and practitioners, providing students, faculty, and staff access to quality healthcare while allowing doctors the autonomy to manage their practices.
However, the legal framework surrounding these agreements is complex, necessitating careful navigation to protect all parties involved. This need has become particularly pronounced following the pivotal Thomas and Naaz case, which has had significant implications for the structuring of these agreements. Here, we explore three critical learnings from working with these universities, offering insights for university in-house lawyers and also General Practice owners and practice managers more broadly.
1. Updating the Flow of Money Following the Thomas and Naaz Case
The Thomas and Naaz case highlighted the vulnerabilities in financial arrangements between healthcare providers and institutions. A key learning from this case is the critical importance of transparency and compliance in the flow of money. Universities and their legal advisors have worked diligently to ensure that payment structures within service agreements are not only fair but also comply with legal standards to prevent disputes and litigation.
To achieve this, agreements now often include detailed provisions on billing practices, revenue sharing, and the allocation of costs associated with the provision of medical services. These provisions aim to clearly delineate the financial responsibilities of each party, ensuring that the flow of money is consistent with legal requirements and best practices in healthcare finance. By doing so, universities can mitigate the risk of financial disagreements and foster a stable working relationship with independent contractor GPs.
2. Maintaining Control of Patient Records
Another critical area of focus has been the control and management of patient records. In light of the increasing emphasis on data privacy and protection, universities are particularly concerned with maintaining the confidentiality and security of medical records. The service agreements have been crafted to clearly define the roles and responsibilities related to patient records, ensuring that universities retain control over these sensitive documents while allowing GPs access as necessary for the provision of care.
This approach not only complies with privacy laws and regulations but also serves to protect the interests of patients and the institution. By establishing clear guidelines and protocols for the handling of patient records, universities can prevent unauthorised access and ensure that medical information is used appropriately and ethically.
3. Ensuring Doctors Remain Independent Contractors
Perhaps one of the most significant concerns for universities in these agreements is ensuring that GPs are classified as independent contractors, not employees. This distinction is crucial for several reasons, including tax implications, liability, and the autonomy of the doctors in managing their practice. The service agreements have been carefully designed to preserve this status, incorporating elements such as the freedom for GPs to set their schedules, make independent medical decisions, and manage their own
insurance and benefits. By clearly defining the relationship between the university and the GPs as that of an independent contractor, both parties can benefit from the flexibility and reduced administrative burden this status provides. However, it requires vigilant monitoring and legal oversight to ensure that the nature of the relationship does not inadvertently shift over time, potentially exposing the institution to unwanted liabilities.
4. Employee GPs
While we have suggested that the University lawyers take a conservative approach, structuring the GPs as independent and the Uni Medical Centre as providing services to them does contain some risk, as those who have been following along for some time will know. There are other university clients we have had who have a lower tolerance for risk and have opted to transfer their GPs to employees. These client’s have had a good response rate on this change, which is great to hear. Our article on Employing GPs covers the details of this arrangement, if you are interested to know more.
5. What Next?
The service agreements between universities and general practitioners operating as independent contractors within university medical centres are a testament to the complex interplay between legal, financial, and ethical considerations in healthcare provision. The Thomas and Naaz case has underscored the need for meticulous attention to the structure of these agreements, particularly concerning the flow of money, control of patient records, and the employment status of doctors. By learning from these key areas, universities and private General Practice alike can better navigate the challenges of providing healthcare services ensuring the protection and well-being of all parties involved.
Our team has extensive experience drafting Service and Employment Agreements for General Practitioners and specialist doctors and has assisted in a variety of arrangements with clinics of all shapes and sizes. To discuss the agreements your practice needs, contact our team here.