The legal and business issues which a retiring physician must resolve will vary depending upon their practice arrangement: sole shareholder, partner in a practice or employed physician.

With increasing frequency, courts are being called upon to evaluate the legality of relationships between providers and third-parties in the context of civil litigation. The facts and outcome in Zimmer illustrate a number of important observations that derive from the line of cases involving civil enforcement of the fraud and abuse laws.

Several important trends virtually ensure that automation of medical practice operations, including certain clinical activities, will grow significantly and rapidly.

One option might entail a semi-retired doctor electing to work a certain percentage of a full workload (e.g., day schedule, weekend call, night call, etc.). Another option might entail the semi-retiring doctor dropping procedures (e.g., dropping OB, no longer doing surgical cases, etc.), while maintaining an office-only practice.

An HMO and its physicians cannot be sued in federal court for breaching their fiduciary duties to patients when they implement a managed care program in which the physicians receive financial incentives to contain costs.

Physicians are rightfully concerned that unfiltered access to online ratings of them without appropriate safeguards may be detrimental to informed patient decision making, and may have distorting effects on patient access to care.

While Independence Blue Cross and Highmark Blue Cross Blue Shield have recently ceded ground on coding and reimbursement methodologies, it remains to be seen whether insurers and physicians will be able to develop the necessary level of trust and collaboration to make innovative systems work.

The question to address is whether or not the current resources dedicated to marketing are used wisely and whether they are sufficient for you to grow and sustain the practice.

The draft compliance program guidance will likely become the standard of care for all physician practices and those practices without some formal plan will be extremely vulnerable when responding to any third party audit for billing purposes.

Physicians who fail to take proper precautions and to correctly structure their practices' relationships with their billing companies risk significant legal and financial liability.