MANAGED CARE SUIT: Doctor Settles Out of Court For $2.5 Million
"A San Diego pediatrician who recently won a major legal victory against managed care restrictions on his practice settled his lawsuit yesterday for $2.5 million," the San Diego Union-Tribune reports. A jury had already awarded Dr. Thomas Self $1.75 million earlier this month but that amount will be set aside, as will tomorrow's hearing for punitive damages, in exchange for the lump sum payment. The jury found that the 77-doctor Children's Associated Medical Group "wrongly fired Self for refusing to limit care for HMO patients." The Union-Tribune notes that "Children's Associated Medical Group is not an HMO, but the physician group contracts with HMOs through an associated corporation to provide care. Therefore, the group is in a crucial position to determine what services are performed" (Dalton, 4/28). The Los Angeles Times reports that Self contended in his lawsuit that "he was fired by the group for advocating the best possible care for his young patients. ... It was one of the first cases to invoke a 1992 California law protecting physicians from such retaliation."
From Der Spinmeisters
The defendants' attorneys argued that the case was never a referendum on managed care, as some had alleged. Rather, it was a "contractual dispute" between the two parties. David Noonan, one of the lawyers, acknowledged, however, that the verdict "may have been influenced by public sentiment regarding managed care." An Associated Medical Group spokesperson said "the group did not agree with the jury verdict and that the settlement did not amount to an admission of wrongdoing." In a statement, they said, "Rather than spending the energy in an appeal process ... the best interest of our organization is to continue the focus on what we do best: providing care for sick children" (Marquis, 4/28). Sherry Bahrambeygui, one of Self's attorney's, said, "[T]he defendants have denied Dr. Self's rights as a physician, as well as the rights of his patients. ... This result is pure vindication." Self said, "I was swimming upstream against the good-old-boy network. But I wanted to show people the position I have taken for quality of care was right." The Union-Tribune reports that the decision has "reverberated across the nation," drawing interest from both sides of the debate and inspiring similar suits (4/28). The Times reports that the case "is believed to be among the first victories of its kind in the country" (4/28).