Page 34 - SAM-0724 v4

SAN ANTONIO WOMEN IN
MEDICINE MEDICINE

Elizabeth Blackwell:

The First Female

Physician in America

Important New Compliance Deadlines By Gabriella Bradberry

By Michael L. Kreager, JD, LLM
More and more women than ever are becoming doctors, with female diploma, gaining the respect of the students and faculty along the way. On
medical students beginning to outnumber their male peers in recent years.1 the morning of January 29, 1849, Blackwell’s efforts proved worthy when
This year adds two more compliance deadlines for physicians and December 31, 2024 This shift in medical school attendance is an exciting development for she graduated top of her class and became the first woman in America to
their medical practices. BOI Reports. The Corporate Transparency Act became effective both the world of medicine and women alike. With this ever-increasing earn a medical degree.5
January 1, 2024. The new law requires small businesses to report to percentage, it is difficult to believe that not so long ago, the number of While Blackwell’s career did not magically develop into one without
September 4, 2024 the Financial Crimes Enforcement Network (FinCEN), a bureau of licensed female physicians was an absolute zero. During the early years of discrimination and challenge, she felt solace in seeing the affects her accom-
New FTC Rule. The Federal Trade Commission adopted a rule in the Department of Treasury, identifying information about its own- American history, a few women worked as apprentices and practiced as plishment had on other women. In fact, Dr. Elizabeth Blackwell even
April that bans most covenants not to compete. ers and senior officers. These reports are called Beneficial Ownership unlicensed physicians, but none were permitted to attend medical school.2 inspired her very own sister, Emily, to pursue a medical degree of her own
Action Required. By September 4, 2024, employers must inform their Information, or BOI, reports. It was not until 1849 that Dr. Elizabeth Blackwell cemented her place into and become a surgeon. Together, the Blackwell sisters established the New
workers that any post-employment restrictions on competition are no longer Deadline for Reporting. All entities formed before January 1, history as the first woman to receive a medical degree in America, thus York Infirmary for Women and Children in 1857, where they pursued the
enforceable. The rule applies to virtually all workers, including physicians. 2024, must file their BOI reports with FinCEN before December 31, helping pave the way for the female physicians of today. mission of providing care for women and positions for female physicians.2
Content of the Notice. The notice must identify the employer and 2024. Entities formed during 2024 must file their BOI reports within Initially, Blackwell did not plan to pursue medicine and instead Blackwell would later go on to open a medical college in New York
must be sent to its workers who are subject to a noncompete. Workers 90 days of formation. Entities formed after 2024 must file their BOI worked as a schoolteacher in Cincinnati alongside her mother and sister. City and eventually move permanently to London where she taught as a
include employees and independent contractors who are subject to a non- report within 30 days of formation. It was not until her close family friend, Mary Donaldson, fell deeply ill professor of gynecology. Throughout her career, she would emphasize pre-
compete, including former workers. The notice must state that the non- Responsible Reporting Person. The small business is responsi- that her perspective and goals shifted.3 While on her deathbed, Donald- ventative care and personal hygiene and eventually assist in the founding of
compete will not be, and cannot legally be, enforced against the workers. ble for filing the BOI report. Virtually all small businesses are subject son, who was likely dying due to uterine cancer, confided to Blackwell that the National Health Society and U.S. Sanitary Commission.2
The notice can be hand delivered, mailed, sent by email or sent by text. to the reporting rule, which includes professional associations (PA) she would have been more comfortable seeking treatment earlier had she Dr. Elizabeth Blackwell passed away in 1910, but the impact she had
Why. The FTC’s rule is effective September 4, however, employers and professional limited liability companies (PLLC). In addition, all been able to explain her symptoms to a female physician. This devastating on women’s rights and the medical world are eternal. During her life, she
must send the notice to workers by that date. The rule effectively bans other physician-owned entities, such as family limited partnerships, confession ignited Blackwell with the goal to earn her medical degree and tirelessly strived to create opportunities for fellow female physicians, and
existing and future noncompete agreements that apply after the end of corporations and limited liability companies must file a BOI report become the physician that her friend had so desperately needed. her legacy serves as a continuous inspiration to persevere even in the face
employment. Only the portion of the agreement that is a noncompete with FinCEN. The road to achieving a medical degree would be filled with many of discrimination. In the words of Dr. Elizabeth Blackwell herself, “It is
will no longer be enforceable. The remainder of the agreement will still Information Reported. Each person owning 25 percent or more obstacles. Blackwell was not the first woman in America to pursue entrance not easy to be a pioneer — but oh is it fascinating! I would not trade one
operate. Amendments to the agreement are not necessary. of the business entity and each officer must provide a photo ID, such into medical school. During the 1800s, few medical schools existed and moment, even the worst moment, for all the riches of the world.”5
Court Challenges. There are several court cases pending that seek as a current driver’s license, which will be uploaded to FinCEN as part none accepted women, leaving women to pursue alternative routes of edu-
to challenge the rule. If a court does not delay the rule before this date, of the BOI report. It is important to remember that the business entity cation. Rather than be discouraged by the odds in front of her, Blackwell References:
employers will still need to send the notice to their workers and refrain must report changes in its BOI information within 30 days, such as a studied rigorously, attended medical lectures, worked as an apprentice, and 1. O’Connell-Domenech, A. (2024, Feb 22). More women than
from entering into new noncompetes. change in an owner’s current residential address. applied to any and every medical school she could find. ever are becoming doctors; here’s why there are still so few. The
Who Is Affected. The rule applies to all employers who are not oth- Failure to Report. There are civil and criminal penalties for will- Finally, Elizabeth Blackwell’s application arrived at the desk of the Hill. https://thehill.com/changing-america/respect/equali-
erwise outside of the FTC’s jurisdiction, e.g., state institutions. Nonprofit fully failing to comply with the law. dean of Geneva Medical College in upstate New York. The dean was ty/4479304-more-women-than-ever-are-becoming-doctors-
corporations are usually outside the FTC’s jurisdiction, but nevertheless, More Information. More information can be found at FinCEN’s eager to reject Blackwell’s application, but along with it came an astute heres-why-there-are-still-so-few/
under certain circumstances, the rule may apply to some nonprofits. website at www.fincen.gov/boi. The law and its implementing regu- letter of recommendation from a well-respected physician she studied 2. Michals, E. (2015). Elizabeth Blackwell. National Women’s
Important Exceptions. The rule does not outlaw a noncompete lations are complex. Talk to your CPA or attorney for advice about with. Rather than risk displeasing a colleague, the dean opted to have the History Museum. https://www.womenshistory.org/education-re-
while the worker is engaged; it applies only after the end of engage- compliance. student body vote on the matter, and much to his surprise, the students sources/biographies/elizabeth-blackwell
ment. The rule grandfathers existing noncompete agreements with BCMS thanks attorney Mike Kreager with the Kreager Mitchell decided to admit Blackwell as part of a practical joke.4 Regardless, Black- 3. NUHW Editors. (2022, March 17). Elizabeth Blackwell.
senior executives making $151,164 or more annually and having final PLLC law firm for highlighting these deadlines. well remained serious in her pursuit of a medical degree and instantly National Union of Healthcare Workers. https://nuhw.org/eliza-
policy-making authority. But the rule outlaws new noncompetes with accepted the invitation with immense gratitude. beth-blackwell/
senior executives after September 4. Employers may still enforce vio- While Blackwell was technically accepted into medical school, she 4. Fuller, M. (2003, May & June). Woman attends medical school.
lations of their noncompetes that occur before September 4. Lastly, a was not met with welcoming arms. Silence overcame the other students Hobart and William Smith. https://www.hws.edu/about/histo-
buyer of a medical practice may still require noncompetes from the the moment she first walked into class. Eventually, her peers would soon ry/elizabeth-blackwell/woman-attends-medical-school.aspx
sellers. Similarly, a noncompete may be required in connection with Michael L. Kreager, JD, LLM, is the founder of Kreager Mitchell overcome their shyness in favor of throwing paper darts at Blackwell. She 5. Biography.com Editors. (2021, March 31). Elizabeth Blackwell
the purchase and sale of an ownership interest in a practice. PLLC, a San Antonio law firm serving the needs of physicians. ignored these attempts of provocation, but when the professors attempted Biography. Biography.com, https://www.biography.com/scien-
More Information. This summary is not exhaustive and does not He has authored several books on physician employment contracts to bar Blackwell from attending classroom dissections, she protested for tist/elizabeth-blackwell
cover all the specifics of the FTC’s rule. You can obtain more informa- for the Texas Medical Association. In addition, he authored the the right to attend.4 Gabriella Bradberry is the Admin/Communications Specialist for
tion about the rule at https://www.ftc.gov/legal-library/browse/rules/ popular guide, “The Physician Employment Contract,” which is in its Despite the continuous pushback Blackwell faced from the commu- the Bexar County Medical Society.
noncompete-rule, and be sure to get legal advice from your attorney. fourth edition. It is a free publication. nity surrounding her, she continued to diligently work toward earning her

34 SAN ANTONIO MEDICINE • July 2024 Visit us at www.bcms.org 35