ER physician settles case regarding understaffing concerns.
Raymond Brovont, MD, an emergency room doctor, will collect $26 million in a wrongful termination lawsuit against EmCare, a physician staffing company. In 2018, Brovont filed a lawsuit alleging he was let go for voicing his concerns about the company’s staffing of only one doctor on the night shift to cover two separate areas of the Overland Park Regional Medical Center in Kansas. Brovont’s worries became even more evident once the hospital’s size doubled. EmCare, owned by Envision Physician Services, provides physician staffing to more than 1,000 contracts with hospitals in 42 states.
“Given the dangerous level of understaffing in Overland Park Regional’s emergency departments, plaintiff was gravely concerned for the safety of the hospital’s patients,” Brovont’s lawsuit explained, and a jury awarded Brovont $29 million in October 2018 – $3 million in economic damages, $6 million for pain and suffering, and $10 million in punitive damages against EmCare subsidiaries in Kansas and Missouri.
Michael Ketchmark, one of Brovont’s attorneys, said at the time, “We proved at trial he was fired for raising his voice. The jury, I think, sent a pretty loud message that when you have these corporations come in and provide managed care they’re required to listen to the doctors’ complaints about patient safety.”
This award, however, was reduced to $13 million after a judge applied punitive damages caps under Kansas law. Both Brovont and the defendants filed appeals, with Brovont arguing that Kansas law should not apply to the Missouri facility. The Missouri Court of Appeals ruled in his favor, although reducing the pay out to $26 million, and the Missouri Supreme Court refused to review the case.
“We’re pleased but not surprised by the opinion,” said Ketchmark. “It was a complete win.” He added, “I think that Dr. Brovont is a real hero in that regard. This is just a complete vindication of everything he tried to do.”
Contract management groups (CMGs) in emergency medicine, also referred to as Physician Practice Management Organizations (PPMOs), provide automated billing services, but “often at the expense of physician autonomy,” according to the Emergency Medicine Residents’ Association (EMRA). Some have questioned whether they serve the best interest of emergency physicians and their patients, and emergency doctors have argued that the systems actually compromise patient care.
“The business model used by these contract management groups is the same one as McDonald’s: use the cheapest labor possible to churn out a mediocre hamburger,” said Mitchell Li, MD, an emergency physician in Chicago. “Expertise is seen as a line-item expense only and patient safety takes a distant backseat to investor profit. Private equity, and, frankly, lay ownership, has no place in medicine. Judgments such as this should empower physicians everywhere to speak up against injustices that they endure on a regular basis.”
Asked whether Overland had changed its ER staffing policy, spokesperson Christine Hamele commented only on the hospital’s procedures and patient care as a whole. She said, “Overland Park Regional Medical Center prides itself on providing high-quality, compassionate care for patients, especially during their most vulnerable time.”