Kyle Carinan discusses corporate practice of medicine in Washington legislature session

In a meeting that echoed with the complexities of healthcare regulation, the Senate Health & Long-Term Care Committee convened to delve into the intricate world of the corporate practice of medicine. The session, held on February 7, 2025, featured Kyle Kernan, the executive director of the Washington Medical Commission, who provided a comprehensive overview of this legal doctrine that governs the relationship between medical providers and their patients.

Kernan began by clarifying that the Washington Medical Commission does not hold a position on the corporate practice of medicine and lacks the authority to regulate it. He emphasized that this doctrine, which restricts certain professions to individual practitioners rather than corporate entities, is rooted in a patchwork of judicial decisions rather than a unified statute. This lack of clear legislative guidance raises significant questions about enforcement and compliance.

The corporate practice of medicine doctrine aims to protect the integrity of the patient-provider relationship, ensuring that medical care is delivered without undue influence from commercial interests. Kernan highlighted a historical case from 1943 involving optometry services, where a corporation's control over practice elements led to concerns about patient care quality. This case set a precedent for how courts view the intersection of business and healthcare, underscoring the risks posed by non-professionals in medical settings.

As the discussion unfolded, Kernan pointed out the variations in how different states approach this doctrine. Some have codified it into law, while others, like Washington, rely on judicial interpretations. He noted that the absence of a clear enforcement authority complicates the regulatory landscape, leaving many questions unanswered, particularly regarding management agreements and the role of hospitals in employing healthcare providers.

The meeting concluded with a call for further exploration of these issues, as the committee recognized the need for clarity in a rapidly evolving healthcare environment. As lawmakers continue to navigate the complexities of healthcare regulation, the implications of the corporate practice of medicine doctrine remain a critical area of focus, with potential impacts on patient safety and the quality of care across the state.