Cardiology groups call off battle over patients

TRAVERSE CITY – Great Lakes Cardiology PLLC and Northwest Michigan Heart and Vascular Specialists PLLC have ended a three-month-old legal battle over access to patients and medical records.

James Christopherson, the attorney for Great Lakes, and Dr. Michael Lauer, founder of Northwest Michigan Heart and Vascular, said the parties have dropped a lawsuit and countersuit related to their disagreements.

Christopherson, a partner with Dingeman, Dancer and Christopherson, PLC, also said a mediated agreement was reached between the two medical groups. The details will remain private, he said.

Lauer went to court in June, charging that many of his heart patients didn't have a chance to remain with him as their cardiologist after he left Great Lakes last spring. Enrico Schaefer of Traverse Legal PLC, represented Lauer and Northwest Michigan Heart and Vascular Specialists in the suit and a subsequent countersuit in Grand Traverse Circuit Court.

Great Lakes filed its own complaint in August. It contended that Lauer and Northwest Michigan Heart and Vascular had defamed its practice and created obstacles to the timely completion of patients' charts.

After the suits were dropped, Lauer said he was glad to put the matter behind him. His enthusiasm for practicing in Traverse City is undiminished, he said. "I am extremely happy to be associated with the Traverse City medical community and Munson Medical Center."

The suit and countersuit put the spotlight on a contentious, high-stakes issue: When doctors and medical groups separate, who exactly gets custody of the patients?

In their dispute, the two sides fired off letters to each other and traded charges in circuit court over the summer. Each accused the other of putting up obstacles to solving their dispute.

The issue of access to patients and their medical records is a complex one that involves privacy concerns, medical ethics and the welfare of the patient. On one level, the battle is over the lifeblood of any medical practice: patients. On another level, it involves the rights of any patient to choose a doctor himself or herself.

A key sticking point: How far does a practice need to go to facilitate a patient's ability to stay with a physician after he or she leaves?

Lauer argued that Great Lakes was not accommodating enough. The group argued it was more than helpful.

On June 3, Lauer sent a letter to Great Lakes saying it "must immediately cease contacts with or attempts to contact patients who were scheduled to be seen by me at GLC on June 2 or thereafter."

His lawsuit was filed in early June and a Great Lakes counter-suit came in early August.

On July 7, 2008, Lauer sent out letters to several sources of referrals, according to court documents.

In his letter to a physician, Lauer complained that he was forced "to go through an obstructive process to get access" to his records. "I am in the process of gaining access to those charts through legal action," he wrote.

If a patient wanted to continue seeing Lauer, the letter asked that the physician have the person fill out a medical records release form and send it back to him. Lauer also expressed the desire to work with the physician again. "I hope that we can work through this transition and I can continue to provide high-quality, friendly care to you and your patients that hopefully you have come to expect."

Several weeks ago, Circuit Court Judge Phillip Rodgers turned down Lauer's request for an injunction that would have required Great Lakes to take more steps to inform patients about Lauer's availability. The steps would have included direct contacts with them over the phone or in person.

In the filings, Schaefer based his arguments partly on what he described as American Medical Association ethical standards. Lauer's complaint said the AMA promotes "reasonable accommodation of patient rights to a physician."

Great Lakes had been "unilaterally assigning patients to other physicians without patient consent and then falsely telling patients that they do not have new contact information for Dr. Lauer," Schaefer wrote in the initial complaint.

Lauer's suit also said Great Lakes Cardiology automatically moved his appointments to other physicians after he left the firm.

In court documents, Lauer also said his inability to access records affected the care given to patients in some cases. Even if these patients did not follow him to his new firm, he should have been able to assist with their treatment during the transition, he said in court filings.

According to Lauer's affidavit, he joined Great Lakes Cardiology in 2006. While at the group, he said, he had hundreds of patients. "The vast majority of patients chose me specifically as their physician based on personal relationships, reputation, referrals from other doctors and referrals from other patients," Lauer said in an affidavit.

"Patients choose physicians, not clinics," he said.

In its own filings, Great Lakes Cardiology said it gave Lauer's patients ample notice that they had the option of choosing him as their physician. The group also denied making it difficult to get in touch with him, saying it gave patients the number for the Munson Medical Center switchboard if they wanted to contact Lauer.

And in its countersuit, Great Lakes said that the physician had defamed the practice in his letters to sources of referrals. Its complaint said "the letters falsely implied that defendant Lauer had not been provided an opportunity to complete medical charts on numerous occasions."

Those letters also attempted "to coerce the addressees into terminating their dealings with the GLC and do business with Lauer," the Great Lakes said in its filings. It suffered financial harm because several referral sources chose "to discontinue the relationship with GL Cardiology."

In court documents, the medical group said it offered Lauer a two-hour window on Tuesdays to complete medical charts that were incomplete at his departure. Lauer said he wanted alternate time periods.

"Dr. Lauer was given more than enough time to complete the delinquent charts when he was employed by Great Lakes Cardiology and chose not to do so of his own accord," Christopherson said in a July 7 letter to Schaefer.

A 1978 Michigan attorney general opinion held that medical records belong to the practice, not the individual physician. Patients must be given access to them, however. And they need to sign a release to have them turned over to another physician.

Great Lakes' countersuit asked for "compensatory damages equal to the amount of losses it has sustained and will sustain, including damages to the plaintiff's reputation." BN