Messenger model: Follow the rules and fly right

Be mindful that this mode of contract negotiation is under the watchful eye of the federal government -- the messenger should only carry your wishes, not make the decisions.

By Tanya Albert, AMNews staff. Oct. 6, 2003.

Sending someone else in to do battle with health plans when it's time to renew a contract can relieve a lot of stress in a physician's life. But if the doctor doesn't understand the ground rules for how these talks should work, it could cause big legal trouble down the road.

In the past two years, the Federal Trade Commission and the Dept. of Justice combined have taken more than half a dozen actions -- affecting thousands of physicians -- against what the agencies saw as questionable use of the messenger model.

Under the model, a physician designates an independent third party to go to contract talks instead of going himself or herself. A union leader, a lawyer or a representative of a nonprofit organization representing physicians are a few examples of such third parties. It's OK for more than one doctor to send the same person to meet with the same health plan, even if they are independent physicians who are competing against one another.

But here's the catch: The messenger has to negotiate the terms of a contract for each physician individually, not collectively. And that's what has gotten physicians into trouble when they've sent messengers into contract talks.

"The messenger [model] approach isn't there to increase physicians' leverage," said Jeff Brennan, assistant director of the Federal Trade Commission's Bureau of Competition. "It is there to create efficiencies in the contracting process."

Physicians are no different from other businesses subjected to antitrust regulation.