Recent protectionist efforts include:
1. Anesthesia. There are efforts by anesthesiologists to try and prevent other parties from profiting or controlling anesthesia. For example, the American Society of Anesthesiologists recently sent a letter to the Office of Inspector General criticizing different practices whereby surgery centers and their owners can profit from anesthesia.
2. Physical Therapists. Physical therapy associations in several states have made efforts to try and prevent orthopedic practices from operating physical therapy practices or providing physician therapy. We have seen renewed efforts in this regard, for example, in Colorado and in Illinois.
3. Radiology. Radiologists, in efforts related to the Stark Act, have tried to narrow the ability for physicians other than radiologists to provide radiology services and profit from radiology services under the Stark Act in-office exception.
4. Pathology. Pathologists, like anesthesiologists and physical therapists, in several states have taken steps to try and enact legislation that would prevent physicians from profiting from pathology services and from entering into “client billing” arrangements.
5. Hospitals. Hospitals and their trade associations have taken significant actions over the last several years to try and prevent physician ownership of hospitals with the effort to try to stop competition from physician-owned hospitals.
This type of economic protectionism in healthcare has the real potential to limit access to care and to stop new evolutions in healthcare. It is very similar to efforts made years ago by the traditional medical establishment to prevent osteopathic physicians from operating on an equal basis as allopathic physicians.
