A national physician staffing firm tried to take over the contract held by Eugene Emergency Physicians to work in local hospitals. The local physicians used a new state law to oppose the move.
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In between shifts in the emergency room, Dr. Dan McGee was in an Oregon courtroom. He was fighting for his practice — Eugene Emergency Physicians (EEP). The group of more than 40 doctors and physician assistants work at multiple emergency departments; it was being replaced by a national company.
“This was big time, David and Goliath stuff,” McGee said. “You see 14 of their lawyers sitting there and you see three of ours.”
Those lawyers argued that ApolloMD, the national company, violated Oregon’s corporate practice of medicine law. The 2025 law bans corporations from taking control of a medical practice’s operations and finances.
The case garnered national interest because Oregon’s new law targets the loopholes large staffing firms have been employing to circumvent state corporate medicine laws.
Money for control
Most states have laws requiring that doctors own medical practices, not corporations. These rules aim to put patient interests ahead of profit motives. Over the last several years, companies have used a model where a doctor technically owns the local practice, but as Erin Fuse Brown, a professor at Brown University, explains, those physician owners are often not involved in care and cede hiring, firing and other operational functions to the corporation.
Fuse Brown said these arrangements are attractive to hospitals because these companies often promise more revenue and take over the responsibilities that come with running an ER.
“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,” Fuse Brown said.
The connection to patient care concerned Dr. Jonas Pologe, who works for Eugene Emergency Physicians, in the Eugene, Ore., area. ApolloMD offered local doctors jobs, but Pologe worried that if he pushed back on decisions ApolloMD made, he could lose work hours.
“There’s certainly a chance that if you make enough of a stink, you think that something needs to change, they can just stop giving you shifts,” said Pologe.
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.
A closely watched experiment
Fuse Brown, policy experts and independent physicians theorized that updating state corporate medicine laws could be a fix to limit the control management companies can exert over medical doctors.
Oregon’s the first state to try this, and the case brought by the Eugene doctors group is the first test of that law. McGee, who leads the Eugene physicians group, says colleagues at other hospitals around the state were literally tuning in to their case.
“You could hear it almost like background music on an elevator,” McGee says he was told. “At key moments, all of a sudden the nurses would break out in a cheer.”
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.
“This is a big victory for independent physician groups over corporate medicine,” McGee said. “This is a game changer.”
The American Academy of Emergency Medicine (AAEM) supported the Eugene doctors as part of the organization’s strategy to protect independent practices. The AAEM president, Dr. Vicki Norton, said Oregon has the strongest law in the country.
“This signals that that law works and we need it replicated in other states to really strengthen their corporate practice laws,” said Norton.
California and Vermont have passed similar legislation to Oregon, and lawmakers in other states, including Rhode Island and New Mexico, are considering related bills.
In Virginia, an independent group of ER doctors who were replaced by a large staffing firm is meeting with state legislators to try to change their laws.
Impact on Oregon physicians
Back in Oregon, the open question is about how the law may impact the physician practice market.
A few of the largest companies, Envision Healthcare, TeamHealth and USACS, declined to answer NPR’s questions about whether this case or the new law changed their outlook on investing in Oregon practices.
Opponents of the legislation warned lawmakers that many physician groups depend on outside investment to survive.
