A global health care company’s aggressive legal tactic is endangering people in the Eugene area by fueling a critical shortage of doctors, some lawmakers say — and they want it to stop.
A group of Oregon state and federal lawmakers have formally asked UnitedHealth’s Optum subsidiary to release local physicians from agreements that block them from working for other companies or practices in the area after they’ve left the giant company, saying Eugene-area patients otherwise are “at risk of catastrophic health outcomes.”
So many doctors have left the Oregon Medical Group since its purchase by Optum four years ago that the company has sent notices cutting off treatment to many of its patients, as The Oregonian/OregonLive reported last month.
But at least some doctors who leave Optum are not allowed to serve area patients’ needs due to legal agreements the company made them sign as a condition of employment, known as a “noncompete” contract.
That is making it hard for Lane County residents to find doctors, according to a bipartisan group of area lawmakers spearheaded by state Rep. Nancy Nathanson. In a formal letter they’ve requested Optum immediately commit “to not enforce restrictive contract language for any medical providers who had such contracts with OMG or Optum and not interfere with those who have left OMG from continuing to provide patient care in the local area.”
“Some of these patients are currently ill and have nowhere to turn,”
The Oregon situation echoes concerns about noncompetes that have arisen around the country. The Federal Trade Commision on Tuesday approved a ban of most non-compete agreements in a rule that’s slated to go into effect 120 days after it’s published in the Federal Register. The U.S. Chamber of Commerce, a lobbying group representing large multinational corporations, has already sued to block the rule.
Nathanson told The Lund Report in an email that Optum should not wait for the FTC rule, saying she calls on the company “to do the right thing right now and agree to let doctors work.”
They should do so, she said, “by not enforcing … restrictive contract language that gets in the way of doctors seeing their patients.”
‘My cat has better health care’
Critics of noncompetes say the agreements harm competition while hurting consumers and workers — and the harmful effects grow as consolidation breeds companies that are larger and more dominant.
UnitedHealth, Optum’s parent company, operates in more than 130 countries and is under increasing scrutiny for alleged anti-competitive practices. So is Optum, now the country’s largest physician employer.
The American Medical Association opposes non-compete agreements and estimates that up to 45% of physicians are covered by one.
Optum did not immediately respond to questions from The Lund Report on how it would respond to the letter. The company also did not respond to a list of questions sent Friday regarding its handling of the loss of doctors from the Oregon Medical Group. In February, asked about criticisms of its management of its Eugene-area subsidiary, an Optum spokesperson responded that “Oregon Medical Group is deeply proud of the clinical services we deliver to our patients.”
Some Lane County residents are less complimentary.
Ed Teague, 72, said he received a phone call from Oregon Medical Group last week reminding him of his annual wellness visit — to check on his blood pressure and cholesterol. The scheduler, he said, was unaware that the company had dropped him from its care.
“It’s very stressful,” he said. “I’m just thinking, ‘My cat has better health care.’”
Optum faced major opposition earlier this year when it proposed buying the 11-clinic company called The Corvallis Clinic that operates in Benton, Linn, and Lincoln counties. The state merger oversight office approved by lawmakers to protect consumers from consolidation’s potential harms approved the acquisition under a loophole set up for companies that cite financial problems.
In an April 2 letter to the Oregon Health Policy Board, Bruce Thomson, a retired family doctor from Corvallis, cited an estimate that Optum sent as many as 13,000 letters to patients who were being cut off by the company. It could take up to two years for all discharged patients to find new providers, he wrote.
As a result of Optum’s more recent acquisition of Corvallis Clinic, Thomson is worried “that the healthcare crisis evolving in Lane county will soon spread to Linn and Benton County.”
He told The Lund Report that people with diseases such as hyper-tension or diabetes regularly need primary care checkups to keep their condition from worsening.
“This is disastrous for people’s health,” he said.
“Thankfully I’m not in the middle of cancer treatment or something. But it’s just extremely unnerving to suddenly find yourself without medical care,”
‘You don't have a doctor’
Laura Kellenbarger, 69, told The Lund Report that she had been trying to get an appointment with her primary care physician at Oregon Medical Group to get a prescription refill for Statin and was having a hard time reaching them. The cholesterol medication requires a doctor to monitor the patient’s liver to ensure safety.
While browsing Nextdoor, a social media website that allows users to share local information, the retired nurse practitioner saw a thread about Oregon Medical Group and clicked on it.
“I started thinking, ‘Oh my lord, what is this?’” she said. “‘Because I've heard nothing from Oregon Medical Group.’”
The thread explained that the company had been dropping patients. Kellenbarger called the clinic chain and finally received a letter notifying her that she no longer had a physician.
It took her weeks of calling around before she found a primary care doctor.
“Thankfully I’m not in the middle of cancer treatment or something,” she said. “But it’s just extremely unnerving to suddenly find yourself without medical care.”
“We are in a health care shortage. Primary care, especially, you could argue, is a necessity. So the idea that somebody is going to run you out of town is just really absurd.”
Garrett Epps, a retired University of Oregon law professor, told The Lund Report that in March he received a “cryptic message” from the Oregon Medical Group telling him his doctor had left.
He wrote back asking if he and his wife were still patients at the clinic. After multiple responses he described as “opaque,” Epps finally was able to confirm he and his wife had lost their doctor.
When he found another doctor, he recalled, the receptionist at the office remarked “more OMG.”
Cindy Meader, a retired bus driver, said that she was already thinking of leaving Oregon Medical Group after constantly being assigned different doctors who weren’t familiar with her medical history and had little time to spend with her.
After returning from Texas to see the eclipse earlier this month, she tried to schedule an appointment for what she suspected was a urinary tract infection.
“And they go, ‘Well, you don’t have a doctor,’” she said.
Meader, 64, asked if she could go to the company’s walk-in clinic for what she expected would be a simple diagnosis followed by a course of antibiotics. Instead, she was told to go to urgent care.
Dr. Nicholas Jones runs Clear Health Direct Primary Care in Eugene. The clinic charges patients a monthly fee and bypasses insurance. He said he has complete control over his schedule and how much time he can spend with patients.
Though he worked for Oregon Medical Group, he never signed a noncompete and calls them unethical when it comes to primary care.
“We are in a health care shortage. Primary care, especially, you could argue, is a necessity,” he said. “So the idea that somebody is going to run you out of town is just really absurd.”
Now, he said, the resulting shortage will hurt care and make for a more wasteful system.
“People are still going to access care, but it’s going to be through urgent care or emergency care,” Jones said. “And a lot of times it's for preventable issues, something as easy as refilling blood pressure medicine that they've been on for five to 10 years.”
