An organization of Tennessee medical practice groups founded in early 2005 to battle some wording in proposed legislation is building on its early success and setting a 2006 legislative agenda.
The Tennessee Group Practice Coalition for Advocacy, originally just a few cardiology practices, is today a multi-specialty alliance of about 40 large groups, defined as 10 doctors or more. Coalition treasurer Bob Lloyd, who is executive director of Mid-State Cardiology in Nashville, says the catalyst for the coalition was a bill "that in our minds would have made it problematical for a physician to own any kind of diagnostic tool. The way the law was stated, we felt like it would have made it problematical for a doctor to own a stethoscope. It was that broad," he explains. "We felt like we needed to get some language changed, and we were successful in getting the language changed such that the bill doesn't affect physician practices at all."
On the heels of that defensive success, the coalition plans a couple of offensive moves in 2006. "We think there are some issues we can address on behalf of patients and physicians that should make things work smoother," Lloyd says.
Specifically, Lloyd points to a Tennessee Supreme Court decision earlier this year that left up in the air whether a group practice employment contract with a physician may include a restrictive covenant. "Typically, a group like ours will end up spending a half a million dollars to bring a physician into a community, and we feel like we need some kind of protection to keep that physician interested and with the group for a prolonged period of time," he says.
Lloyd notes that members of his coalition couldn't look to the Tennessee Medical Association for assistance with such legislation since TMA members might find themselves on either side of the issue. He notes, however, that the coalition is certainly behind TMA's efforts on tort reform.
Two attorneys with group practices in Tennessee are working to draft legislation for the coalition regarding the restrictive covenant issue, and then the group will look for sponsors for the 2006 session.
Another issue on the coalition's agenda is the state's certificate-of-need process, which Lloyd contends "is not acting in the best interests of the patients right now." While Gov. Phil Bredesen has succeeded in some reform of the process, Lloyd says, "I suppose he was successful within his goals, but it is still a very politically driven process, and basically it blocks a lot of diagnostics from being in a more accessible environment. It restricts who can do certain kinds of diagnostics."
Lloyd estimates that about 90 percent of Tennessee's large physician groups are involved in the new coalition.