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As a subscriber you can listen to articles at work, in the car, or while you work out. Subscribe NowA longtime physician at Indiana University Health claims he was demoted and later terminated after he objected to a directive to limit the time he spent on key aspects of patient visits to 10 minutes or less.
IU Health initially declined to comment on a lawsuit filed in Marion Superior Court by Dr. Brian Leon, who had been an internal medicine physician at IU Health’s primary care facility near University Hospital.
But late Tuesday, a spokesman said in an email to IBJ that “no such 10-minute goal exists for patient visits anywhere within IU Health.”
Leon is suing Indiana University Health Care Associates Inc., doing business as IU Health Physicians, a large medical practice of primary and specialty care doctors that operates as a joint venture between IU Health and the IU School of Medicine.
The lawsuit claims breach of contract, unpaid wages, fraudulent misrepresentation and numerous other claims.
The hospital system, which said Monday it could not comment on pending litigation, has filed to move the case to U.S. District Court in Indianapolis.
In his complaint, Dr. Leon claims IU Health Physicians suffered annual deficits of more than $200 million between 2016 and 2018. In response, IU Health transferred more than $700 million during that period to cover the deficits.
As a result of the economic losses, the leaders at IU Health Physicians’ primary care unit pressured doctors to see as many patients as possible, the lawsuit alleges.
To do that, they set a time goal of 10 minutes for electronic medical record time (or EMR time) per patient, per visit, according the lawsuit. The suit describes EMR time as including “(i) reviewing a patient’s records, test results, labs and consultant notes, (ii) visiting with a patient in person, by phone or virtually, (iii) placing orders and (iv) completing and entering the write up after the patient’s visit.”
However, Jeff Swiatek, the IU Health spokesman, said in an email that EMR time does not include “the face time a physician spends directly with the patient (listening, diagnosing, treating them).”
Dr. Leon expressed his judgment that 10 minutes was “woefully inadequate and inappropriate for his patients’ highly complex illnesses,” the complaint said.
He added it was inconsistent with the medical practice’s directive, the Hippocratic Oath, patients’ rights and the customs of physicians board-certified in internal medicine, where 20- to 30-minute return visits and 40- to 60-minute new visits were traditional.
In response, Dr. Leon alleges, the leadership of IU Health Physicians relieved him of his position as medical director of the south central region, and local leader of the Indianapolis medical practice.
That was despite high ratings throughout his career, Dr. Leon said in his complaint.
“Throughout his more than 23-year career with (with IU Health Physicians), Dr. Leon cheerfully and enthusiastically focused on caring for his nearly 2,000 patients and teaching” at the IU School of Medicine, the complaint says.
The demotion was followed by a “nonrenewal letter” of his contract in October 2020 that Dr. Leon said amounted to a termination. He is now working as assistant medical director at Community Health Network, according to his LinkedIn page.
Dr. Leon said he was subjected to a hostile work environment “in an effort to demote and get rid of him.” That included efforts to inflict “great humiliation” upon him by making him stand in a hallway one day while leadership discussed his performance.
The reason for the hostility, Dr. Leon claims, was in part due his pushing back against the mandate for short visits with patients.
He said leadership directed him to “keep his mouth closed,” “sit on his hands,” keep his ideas to himself and do what he was told, the complaint said.
Correction: Due to an editor’s error, IU Health spokesman Jeff Swiatek’s last name was misspelled in an earlier version of this story. You can see other corrections here.
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There are two sides, but jeesh. Moved to Direct Primary Care model years ago, and never been happier.
Scott B,
What is a Direct Primary Care Model and how is it practiced?
Mary B. ~ https://www.aafp.org/about/policies/all/direct-primary-care.html
Mary – and here’s a search link…
https://mapper.dpcfrontier.com/
Bingo.
10 minutes. A one-size-fits-all approach is never appropriate. Woe to the patients.
No shocker as there is no health system in the state that likely runs their entity as much like a shareholder-owned entity than IU Health….
My PCP moved to IUH several years ago, then moved out of state. My PCP now is with a different system. As I am getting older, a 10 minute limit would never suffice. Glad Dr. S and I have both moved on.
No wonder IU can’t keep employees/Doctors. Its all about money now days. Thats why we left and went to a different health network.
My past experience with IU Health Physician’s (a number of years ago) was horrible. The doctor’s (all except one) acted as if they knew everything and the patient knew nothing. The arrogance! I do all my care with Community Health Network, and without exception, the doctors listen to my input and consider it fully, they are compassionate, and take more time with me than I expected.
And now IU has the issue of making so much money at the expense of their patients that they are trying to make it look like they are giving back to the community by building facilities that will just make them more money.
My advise – go to where the doctors put the patient first. And it seems to me, that would be anywhere beside IU Health!
Don’t forget all the grants they have received too. And private donations over the years.
Hospitals look at primary care as a referral pipeline only. They make their money from specialists and surgeries (whether patients need them or not). If you’re a primary care doctor (or any doctor, really) stop working for hospitals. Build a membership-based practice and take as much time with patients as they need, while making care affordable.
I remember my doctor who took care of me and my children and he sat on the Broad of IU he was gDoctor Joesph M Black he is gone now but he is rolling in his grave how IU Health has become. Doctor Joe made house call when I was a child. And he didn’t rush to put you on a pill that causes more harm than good.
Miss those commences doctors and we need more of them.
IU now fires great employees if they speak up and try to take care of their patients and staff employees who are over worked. What happen to patients care??