Sisters of Mercy suit bears on local issues

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Metaphors are flying. Some think its the pot calling the kettle black. Others say its comparing apples to oranges.|ret||ret||tab|

But whatever metaphor one uses, the fact is a Sisters of Mercy group has sued an Atlanta hospital to stop its competition-eliminating practice of forcing managed care companies to sign exclusive contracts with it. That practice has effectively shut out the Sisters of Mercy-sponsored hospital system there.|ret||ret||tab|

But competition in health care is just what the doctor ordered, and exactly what the Woman's Clinic here wants from another Sisters of Mercy health system St. John's Health System Inc.|ret||ret||tab|

At St. John's, doctors who leave its employment must sign agreements not to compete with the hospital for patients for a period of time. |ret||ret||tab|

And the Woman's Clinic doctors can't offer a birthing center or outpatient surgery for five years from when they left St. John's employment.|ret||ret||tab|

The irony of the Georgia suit is not lost on Dr. David Redfern, one of the doctors in the group suing St. John's.|ret||ret||tab|

Eight doctors here, six of them obstetricians with the clinic, filed a federal lawsuit May 24 seeking to end the exclusive contracts they said St. John's has with managed care organizations. The suit also demands that St. John's stop requiring doctors who choose to leave its employment to sign noncompete agreements.|ret||ret||tab|

But there's no comparison between the two suits, said Mike Peters, St. John's spokes-man. "It's apples and oranges," he said. The local hospital is sponsored by the St. Louis region of the Sisters of Mercy Institute, which has 25 regional branches throughout the United States. It has nothing to do with the Sisters of Mercy-sponsored hospital in Atlanta, Ga. St. Joseph's whose health system in May 2000 filed suit against Northside Hospital for unfair competition.|ret||ret||tab|

According to the sisters' Web site, the Atlanta hospital is sponsored by the Baltimore, Md., Sisters of Mercy region. Peters said the two regions operate separately as businesses. |ret||ret||tab|

The Missouri lawsuit's claims are similar to claims in the Georgia suit where St. Joseph's accused Northside Hospital of requiring customers of certain health insurance networks in a specified area to go to Northside for all medical services, according to the Atlanta Business Chronicle.|ret||ret||tab|

According to David Harlan, the St. Louis attorney representing the Woman's Clinic, "The Sisters of Mercy cried foul'" at the unfair competition that shut them out of the lucrative birth-ing market in Georgia. |ret||ret||tab|

Harlan added, "It certainly appears that the Sisters of Mercy on a national level are taking an inconsistent position the right hand doesn't know what the left hand is doing. It appears that they take whatever position is in their interest at the moment and not necessarily what is right."|ret||ret||tab|

Although Northside in Atlanta stated the Georgia lawsuit was frivolous, it nevertheless on Sept. 7 voluntarily "eliminated all exclusive provisions in managed care contracts with insurance companies," according to an official statement released by the hospital.|ret||ret||tab|

And just in the nick of time, apparently, because the Georgia legislature in its most recent session considered bills that would make it illegal for hospitals to have exclusive contracts with insurance companies if such contracts hindered patients from obtaining services at another hospital within a one-mile radius.|ret||ret||tab|

The outcome of the Georgia lawsuit is yet to be known, but Redfern said he doubts that it will be dismissed because the punitive damages demand is $50 million. |ret||ret||tab|

Northside Hospital there was able to demand exclusive contracts with managed care organizations because it dominates the obstetrics market, delivering 16,000 babies a year, according to the Chronicle.|ret||ret||tab|

And now the American Medical Association has entered the arena with a statement in support of patient choice in relation to the local lawsuit.|ret||ret||tab|

"Freedom to select one's physician and health plan is essential, and any barrier to free choice restricts access and compromises quality care," Rosary A. Payne, legal counsel for the health division of the AMA, said in a Sept. 12 letter to Redfern.|ret||ret||tab|

She added, that although the AMA doesn't advocate for either party of the local suit, "the AMA does advocate for quality health care, patient choice and access in regard to physicians, and AMA has policy and ethical opinions that support those principles."|ret||ret||tab|

Further, the AMA lawyer wrote, "any covenant that restricts or disrupts a physician's ability to practice medicine in a specific area or for a specific period of time deprives patients of care and undermines established patient-physician relationships."|ret||ret||tab|

The AMA attorney cited statements from its Council on Ethical and Judicial Affairs: "Free choice of physicians is the right of every individual ... freedom to select a preferred system of health care and free competition among physicians and alternative systems of care are prerequisites of ethical practice and optimal patient care." |ret||ret||tab|

The Greene County Medical Society has issued a similar statement in support of patients' rights.|ret||ret||tab|

The medical society claimed that more than 90 doctors have left the area in the past few years. Peters said that St. John's had a 7 percent turnover last year from doctors retiring or leaving the area.|ret||ret||tab|

Redfern and his group claim that St. John's shuts them out of the market for birthing facilities and outpatient procedures. Before they could resign as employees, they had to sign the noncompete agreement that forbade them to offer those services.|ret||ret||tab|

In addition, employment contracts that St. John's requires its doctors to sign forbid doctors from practicing medicine for two years within a 25-mile radius of the health system's main campus at 1235 E. Cher-okee, according to the clinic suit.|ret||ret||tab|

Redfern said that such contract provisions are "unethical if they are excessive in geographical scope or in time, or if they don't reasonably accommodate the patient's choice of physician."|ret||ret||tab|

"These business practices are disruptive to the continuity of basic care and potentially deprive the public of medical services," Redfern said. "They are just counterproductive to performing quality care." |ret||ret||tab|

The clinic's lawsuit also addresses concerns that its doctors, who now have an annually renewable contract for services with St. John's, will be shut out in the future. |ret||ret||tab|

Peters previously stated that the doctors won't be terminated from employment. Redfern countered, "The technical term may not be terminated' but they will shut us out." |ret||ret||tab|

He said when new large clients join the network, a new network is created, and that new network is the one that will exclude the doctors. |ret||ret||tab|

Dr. David Barbe, president of St. John's regional doctor's group, Regional Medicine of the Ozarks, and chairman of the Missouri delegation to the AMA, said the AMA letter indicates that it understands that "managed care is a fact of life, and Springfield is no exception."|ret||ret||tab|

He said the doctors of the Woman's Clinic don't understand that St. John's "isn't the bad guy. The market is." Managed care is a market-driven phenomenon because the general public wants lower rates and to get lower rates, they have to give up some of their freedom to choose.|ret||ret||tab|

"The AMA acknowledges that patients are accepting a limitation of free choice when they sign up with a managed care plan."|ret||ret||tab|

Barbe added, "It's not St. John's forcing it down someone's throat. It's a way bigger fight than with St. John's. I don't think (the Woman's Clinic doctors) realize that."[[In-content Ad]]