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What Nurse Practitioner Practice Expansion Means for Doctors

March 27th, 2020 by

nurse practitioner practiceBy: Jeff Cohen

The issue of scope of practice is front and center in Florida right now with the expansion of what nurse practitioners (and nurse midwives) are legally permitted to do.  The newly enacted 464.0123 allows for qualified APRNs (there is specific criteria) to practice independent of a supervising physician in the following areas of medicine–primary care, family medicine, general pediatrics, and general internal medicine.

Even more, assuming they meet the membership criteria for admission to a healthcare facility medical staff, they may admit patients, manage patient care, and discharge patients.  One of the only preserved connections with a physician established by the law is if the APRN practices at a healthcare facility, a transfer agreement including a physician is required.  Additionally, the new law establishes a Council On Advanced Practice Registered Nurse Autonomous Practice, two members of which are appointed by the Board of Medicine and an additional two appointed by the Board of Osteopathic Medicine.       read more

How to Add Aesthetics to Your Dental Practice

February 6th, 2020 by

aesthetics dental inject botoxBy: Chase Howard

Botox. Fillers. Lasers. The aesthetic options for patients today are endless with more and more treatments available all the time. The “MedSpa” world is booming, and anyone can get in on the expected growth, including dentists. If you’re a dentist and you’re thinking about adding aesthetic treatments to your practice, you should first consider the following:

  1. Scope of Practice. While most medspas provide full body aesthetic treatments, Dentists are limited to providing treatments that are with her or his scope of practice. For example, Botulinum Toxin-A may be prescribed by a dentist, but is limited to the face and neck of patients. This also means that for nurse practitioners working under the supervision of a dentist, they too are limited in practice. While certain other treatments don’t require any specific medical license or training, dentists should evaluate the type of treatments they wish to provide or supervise to ensure it is within their scope of practice.
  2. Ownership. While medspas may be owned by anyone, including non-licensed providers, Dentists must be careful if taking on business partners due to corporate practice of dentistry. Under Florida law, no person other than a Florida licensed dentist, nor any entity other than a professional corporation or limited liability company composed of dentists may employ a dentist in the operation of a dental office. While most aesthetic services are not dental services, a non-dentist may not directly employ a dentist. Violation of these laws will subject the dentist to disciplinary action. If you’re a dentist in Florida, you can legally add limited aesthetic treatments to your practice. If you’re opening a new business with non-dentist partners, however, you will need to be cautious of these laws.
  3. Keeping Things Separate. Adding aesthetics to your practice carries not only financial risk, but also professional risk. It’s recommended that rather than operate and bill for aesthetic services under your dental practice entity, incorporate a new entity to keep your new business separate from traditional practice.
  4. Regulatory Compliance. Although aesthetic treatments are primarily elective and paid in cash, certain Florida laws still apply to dentists, patients, and marketing and referral arrangements. Dentists must maintain compliance with the Florida Patient Brokering Act when it comes to marketing or referral arrangements. Understanding these laws and exceptions is significant when it comes to avoiding scrutiny.
  5. HIPAA. While it may seem obvious, many believe that because aesthetic services are elective, patient confidentiality does not apply. That is simply not true and providers must maintain compliance with HIPAA, even for such elective treatments.
  6. Training. Anytime a medical business is expanded with the addition of new services, it is vitally important to be well-trained and educated in delivering such treatments. Even if you are not individually performing a treatment that you supervise, it is highly recommended that you be trained in such procedures. Aesthetic and elective services are just as highly litigated by unhappy patients and patients that feel as though a treatment resulted in negative outcomes. Even as a supervising providing, your license is at risk.

While there are many more considerations to adding aesthetic services to your dental practice, the above stated would be sufficient to get a dentist in Florida started on the path to adding a new line of business to their traditional practice.

Medical Practices & MedSpa Startups: Corporate Considerations

August 27th, 2019 by

medspa startupsBy: Chase Howard

Deciding you want to open your own medspa or start a medical practice is the first and most important step in creating something unique and building a brand. Understanding how to properly “start” that business from a legal perspective, and doing so correctly can be the difference between success and failure.

As a physician in a private, solo-practice, or the business owner of a medspa startup, proper strategy is key. Understanding your corporate structure, developing a business plan, and compliance with the laws will help eliminate pesky obstacles that will slow your growth.

When working with start-ups the following steps should be given plenty of time and attention. read more

Florida Physician Supervision for Non-Physician Providers

August 26th, 2019 by

florida physician supervisionBy: Chase Howard

In Florida, a licensed physician can provide supervision of healthcare providers that are not physicians under certain circumstances. Understanding who a physician can cover and under what circumstances can help protect your license and avoid receiving a complaint by the Florida Department of Health.

In every case, when a physician agrees to supervise another provider, Florida law requires certain documentation and notice to be filed. read more