They ordered Gomez to either stop practicing or only operate under the supervision of another surgeon. He began considering moving his practice to another hospital.Ībout the same time, according to court documents and interviews, Gomez was visited by Memorial Hermann administrators who presented data that allegedly showed Gomez's patients had a higher mortality rate than those of other surgeons. In 2009, after more than a decade at Memorial Hermann, Gomez said he became concerned about cost-cutting measures, such as reducing the staff of intensive care nurses, which he believed compromised patient care. He obtained privileges at Memorial Hermann in 1998 and became a specialist in "off pump surgery," a procedure that eliminates the need for a heart-lung bypass machine during open heart surgery and leads to quicker recoveries and shorter hospital stays, saving patients $50,000 or more in medical costs. Gomez, 51, earned his medical degree from Baylor College of Medicine and did his residency at the University of Texas Health Science Center in San Antonio. In recent years, however, other providers have muscled in on Memorial Hermann's territory, none more aggressively than Houston Methodist, which in 2010 opened a 193-bed hospital with 15 operating rooms and recruited Gomez. Memorial Hermann has long-dominated the market in the Energy Corridor in west Houston, prospering from the well-paid, well-insured oil and gas workers who use the hospital's services.
The data was used to improve patient care, not hurt Gomez, she said. But in a brief filed with the Texas Supreme Court in connection with the Gomez case, it defended peer review as a fair, thorough process that protects patients from bad doctors and aids hospitals in providing quality care.Īlex Rodriguez Loessin, a Memorial Hermann spokeswoman, also defended the hospital's peer review process, which in Gomez's case, relied on data collected by the Society of Thoracic Surgeons. The Texas Hospital Association, which represents more than 85 percent of the hospitals in Texas, did not respond to a request for comment. The case settled before it went to trial. In one case in Texas, two doctors alleged they were dropped from a hospital, its health maintenance organization and its managed care network when they invested in a rival facility, said R.J.
#Gomez peer reviews professional#
The American Medical Association, which represents about 250,000 doctors nationwide, said it knows of several court cases around the country in which hospitals were accused of denying physicians admitting privileges based on economic factors rather than professional competence. "Play ball with us or we'll use the peer review process to hurt you."
"The whole process is being perverted to allow hospitals to use the peer review process as a cudgel to get doctors in line," said Brent Walker, a Dallas lawyer specializing in health care. Gomez's suit focuses on peer review, a confidential process conducted by a committee of physicians to weed out bad doctors, but one that legal and health care specialists say is sometimes manipulated to prevent doctors from moving their patients and practices to competitors.
#Gomez peer reviews trial#
What makes this case unusual is that it has made it to trial such suits are typically settled and sealed long before the details of the business disputes between hospitals and doctors become public in court filings. "Without doctors, what are you going to do?" said Rocky Wilcox, general counsel of the Texas Medical Association in Austin. As a result, hospitals fight fiercely to hold onto doctors, using tactics that range from providing high quality nursing support to putting specialists such as anesthesiologists under exclusive contract to prevent them working at other facilities. Independent doctors with admitting privileges are vital to hospitals since they refer patients, and specialists like Gomez, who perform six-figure procedures with high profit margins, are particularly important, health care experts said. Memorial Hermann denies the allegations, but the case, nonetheless, opens a rare window on the fierce competition among hospitals and the lengths to which they might go to protect their business. Gomez's lawsuit, which went to trial last week, charges Memorial Hermann with defamation and restraint of trade. "It turns out I was coming between administrators and market share," Gomez said. It was a contention based on manipulated data, according to a lawsuit filed in state district court in Harris County, but one that allegedly became part of a "whisper campaign" by Memorial Hermann to smear Gomez's reputation and keep patients from leaving the hospital with the surgeon. Soon, word started leaking that patients appeared more likely to die under Gomez's care.
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