A MARTÍNEZ, HOST:
Most states have laws requiring that doctors, not corporations, own medical practices. These rules are intended to put patients ahead of profit. Large companies found loopholes, so lawmakers in Oregon tried to close them. Reporter Alex Olgin reports on how a new law is working out.
ALEX OLGIN: In between shifts in the ER, Dr. Dan McGee was in an Oregon courtroom. He was fighting for his practice, Eugene Emergency Physicians. The group of more than 40 doctors and physicians' assistants staffed several emergency departments and was being replaced by a national company.
DAN MCGEE: This was big-time David and Goliath stuff. You see 14 of their lawyers sitting there, and you see three of ours.
OLGIN: Those lawyers argued that ApolloMD, the national company, violated Oregon's corporate practice of medicine law. A doctor technically would own ApolloMD's practice in the Eugene area, but the local group's lawyers asserted that the corporation behind the scenes would control the finances and operations.
ERIN FUSE BROWN: It's basically money for control.
OLGIN: That's Erin Fuse Brown, a professor at Brown University. She says that's a trade-off that practices make when they turn to these national management companies. The company often takes over doctor hiring and firing and other operational decisions, she says, while promising more revenue and taking on the responsibilities that come with running an ER.
BROWN: That starts to make the practice itself beholden to the financiers. There's worry that these investors or these corporate management companies should not be totally controlling the operations and the clinical decisions of those who are trained to deliver patient care.
OLGIN: That's what concerned Dr. Jonas Pologe. He works in the Eugene physicians group. ApolloMD offered him and other local doctors jobs, but he worried that if he pushed back on decisions ApolloMD made, he could lose work hours.
JONAS POLOGE: There's certainly a chance that if you make, you know, enough of a stink, if you think that something needs to change, they can just stop giving you shifts.
OLGIN: ApolloMD's CEO, Dr. Yogin Patel, said the group doesn't infringe on the way its doctors practice. He says the company is being unfairly lumped in with broader concerns over physicians' feelings of disempowerment at the hands of corporate medical takeovers. Policy experts think that updating corporate medicine laws could be a fix to limit the control these management companies can exert over medical doctors. Oregon's the first state to try this. Doctors and nurses across the state tuned into the hearing while at work.
MCGEE: You could hear it almost like background music on an elevator. And at key moments, all of a sudden, the nurses would break out in a cheer.
OLGIN: They heard the federal judge question whether ApolloMD's setup was, quote, "a shell game," unquote. Before any ruling, the hospital system dropped its plan to work with ApolloMD and struck a deal to stick with McGee's local group of doctors.
MCGEE: This is a big victory for independent physician groups over corporate medicine, and this is a game-changer.
OLGIN: Dr. Vicki Norton agrees. She's the president of the American Academy of Emergency Medicine. The organization backed the Eugene doctors in this case. It's part of its strategy to protect independent practices.
VICKI NORTON: This signals that that law works, and we need it replicated in other states to really strengthen their corporate practice laws.
OLGIN: Lawmakers in Vermont, Rhode Island and New Mexico have introduced similar bills. And in Virginia, an independent group of ER doctors who were replaced by a large staffing firm are meeting with state legislators to try and change their laws.
For NPR News, I'm Alex Olgin.
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