Houston’s medical center is known worldwide, and hospital competition around town is pretty cutthroat.
This is especially true for doctors with admitting privileges, who are extremely valuable to hospitals because they bring vital private referrals from their practice and beyond, and many are able to perform procedures that yield high profit margins.
But one of these independently credentialed doctors, Miguel Gomez, an experienced heart specialist, took the contest to the next level after he filed a lawsuit against Memorial Hermann in 2012.
In his claim against the behemoth hospital, Gomez alleges that Memorial Hermann purposefully and fraudulently, if not slanderously or defamatorily, skewed data on his performance, including his death rate statistics, by including incorrect information and spreading the falsities ahead of his departure for Houston Methodist. Memorial Hermann went as far to ask Gomez to quit or work under the direction of another surgeon once they caught on he was intending to leave for Methodist.
Specifically, Gomez said he found discrepancies in his performance data, like information on a patient that wasn’t his, and insinuations from presentations at Memorial Hermann that patients were more likely to die in his care.
Such a revelation was a devastating blow to his reputation in the small network of Houston medicine and resulted in a significant decline of referrals to Gomez.
He said the gossip was based on manipulated data that was part of a larger “whisper campaign” by Memorial Hermann to try and keep their market share of patients from following the visionary surgeon elsewhere; Gomez made a name of himself performing cutting-edge heart procedures with high-tech robot tools that significantly lowered costs of procedures for patients and the hospital.
Despite his leadership and 10-year tenure with Memorial Hermann, the board-certified cardiothoracic surgeon said he ultimately decided to move down Fannin after budget cuts began to affect the quality of patient care.
As a specialist, Gomez is particularly valuable in the field and no stranger to the fierce tactics used by hospitals to keep their experts close to the chest, such as hiring the best nurses and requiring anesthesiologists to sign noncompete employment agreements to prevent them from jumping ship.
Trial for Gomez’s suit began last week, with a major portion of the complaint focused on accessing peer review — the confidential process a committee of physicians uses to cut out unqualified doctors. Gomez, fellow doctors, and legal specialists agree the method is sometimes faulty or manipulated with intended effects to harm.
“The whole process is being perverted to allow hospitals to use the peer review process as a cudgel to get doctors in line,” Brent Walker, a Dallas lawyer specializing in health care, said in an interview with The Chronicle. “Play ball with us or we’ll use the peer review process to hurt you.”
In a brief filed with the Texas Supreme Court, the Texas Hospital Association, which represents a large majority of Texas hospitals, stood by the integrity of the peer review process, defending the practice as fair and thorough.
Memorial Hermann’s spokeswoman Alex Rodriguez Loessin took a similar stance, describing the contested data as an important tool to improve patient care, rather than a scheme devised to harm Gomez’s reputation.
Despite the closed-door process, a state law designed to prevent anti-competitive behaviors by hospitals requires the peer review process to make its data available to a doctor if he can show the findings were used to stifle competition.
Scienter aside, Houston Methodist has been encroaching on Memorial Hermann’s turf for some time, opening a 193-bed, 15-opearting room hospital in 2010, and the two have been competing for the lion’s share of Houston’s health care dollars ever since.
Amidst deep uncertainty in the U.S. health care system, Memorial Hermann and Houston Methodist aren’t the only hospitals looking to do “what’s best for patients,” not to mention right for hospitals checkbooks. Just recently, M.D. Anderson’s president stepped down after a series of failed investments and less than successful implementation of IBM’s Watson patient diagnosis program.
Gomez could have some luck with securing the peer review findings because he isn’t the only former Memorial Hermann employee who endured the pressures of forced loyalty.
In 2009, breast cancer surgeon specialist Jo Pollack faced threats from Memorial Hermann executives that she would be committing “political suicide” and jeopardizing her practice if she did not continue with the referrals.
“They didn’t want anything outsourced,” Pollack said in an interview.
Gomez would like compensation for lost revenue, harm to his reputation, as well as the mental anguish he suffered during this ordeal, but time will tell if the court will agree he is entitled to the peer review information.
Most cases like this settle before they ever reach a court room, which begs the question of what Memorial Hermann was so willing to fight f0r.
At any rate, hospitals want and need money, and they’ll do whatever it takes to get you in bed — a hospital bed, that is.