Doctors sue Envision Healthcare, claiming that equally funded private companies should not run ERs in California.

The lawsuit alleges that California law prohibits companies from practicing medicine. Many states have similar laws but have not yet implemented them.


A team of paramedics has sued Envision Healthcare, a major healthcare company, alleging violations of California law prohibiting companies from conducting medical operations when they took over the emergency department at Placentia-Linda Hospital in Placentia, California, in August.

The lawsuit was filed by the American Academy of Emergency Medicine Physician Group, a unit of AAEM, a non-profit medical organization that provides administrative services to medical teams. For-profit Envision Healthcare says it is the largest emergency medical team in the country, working with 540 health care facilities in 45 provinces. Envision is owned by KKR, a private equity power company.

Among them, Envision and TeamHealth, owned by the independent equity firm Blackstone, controls at least one-third of U.S. emergency departments.

The lawsuit, filed in a California district court, does not claim compensation. It is asking the court to suspend Envision from operating in Placentia-Linda and other hospitals in California, where the case claims it operates at least a dozen emergency departments. Before Envision took over the contract to manage the emergency department at Placentia Hospital, the AAEM team had department staff.

California is blocking the practice of the medical business to prevent commercial influences, such as for-profit, polluting medical practice. California law prohibits companies or individuals from having unlicensed contraceptives from developing drugs, assisting with unauthorized medical procedures, hiring doctors, or having medical procedures.

More than a dozen other states have similar laws.

But in recent years, as private firms and other companies have swallowed up a host of national healthcare industries, ordinary lawyers and government medical boards have done little to enforce laws. As a result, AAEM officials said they felt compelled to do something. Because California is often the health care bellwether, the team hopes the suit will bring attention to the issue.

"The problem of corporate integration has really reached the top of the emergency room," said AAEM medical officer Dr Robert McNamara, a professor and chair of emergency medicine at Temple University Medical School. “Through this epidemic, doctors were deprived of their salaries and denied doctors the right procedure, which is their right, when talking about patient safety. We would like this model to be a model for other professionals, where doctors feel that private equity and corporate influences are not in the best interests of patients. ”

Private companies are taking over debt-making companies and hoping to sell them at a profit in a few years. The short-term approach encourages private business firms to increase profits for the companies they acquire by reducing costs, such as employee benefits and wages, or raising prices for services and goods.

When Envision took over the emergency services at Placentia Hospital, he did so by finding a medical team, the case was disputed, and he created a separate legal entity to control the medical team. That’s the Envision business model, the suit is suspected, and the organizations are managed and operated by people who are employed or affiliated with Envision.

"The medical director of the medical association is appointed, and the choice is made by Envision," the suit said. "Decisions are not made by medical directors."

Envision, a privately owned company, provides pay to hospitals if there are contracts, the lawsuit alleges, to close “legal medical teams,” such as those affiliated with AAEM.

Envision's control over physicians' practice is “deep and widespread,” says the case. For example, Envision determines how many and which doctors are hired, their compensation and work schedules, and sets other employment policies, staff levels and contact numbers for patients. Recognition governs coding decisions with debt-paying patients and / or insurance providers for such services without telling doctors what has been charged, the case said.

The case also alleges that Envision is establishing internal standards for treating patients, a form of clinical supervision. Envision is placing doctors' performance against standards, "with the intent to" distort and distort "independent judicial decisions, the lawsuit said.

AAEM is not the only emergency medical team hoping to bring consideration to the practice of the practice business. A community-based company called Take Medicine Back, co-founded by McNamara and Drs. Mitchell Louis Judge Li, a paramedic, hopes to "restore the integrity of specialists in the emergency medical profession by our special cleansing of private and corporate equality. Interests that damage our doctor-patient relationship and threaten our longevity in the workplace."

In an interview, Li said: "Practicing under this company model is tantamount to betraying Hippocrates' oath and resulting in moral damage." But, he added, young doctors are facing a challenge, especially the huge student loan debt that they are carrying, an economic burden that could discourage them from talking about problems caused by drug combinations.