Lawsuit against ValleyCare Health System headed to trial

Patients' rights group claims health organization has monopoly on providing medical care

A lawsuit filed by a patients' rights group against ValleyCare Health System appears to be headed to trial.

The Patient Physician Alliance, which bills itself as a grassroots organization based in Berkeley, states in its claim that ValleyCare, which operates a hospital in Pleasanton and medical offices in Livermore, "has hired doctors through an illegally formed entity in violation of state law."

In its claim, filed in Alameda County Sept. 2, the alliance said ValleyCare must have 40 participating doctors in 10 different specialties in accordance with state law. The suit also alleges that the medical provider engages in unfair business practices.

"Specifically, the hospital is using its power to refer patients to favor its employed physicians over community doctors; it is using its real estate holdings to force doctors out of their offices and ultimately out of private practice altogether as a means of recruiting physicians into the hospital's controlled group," said Charles Bond, an attorney representing the Patient-Physician Alliance.

Bond said because of this, patients will have less choice as to who cares for them.

"The hospital is using unfair strong-arm tactics to drive private physicians out of business so the hospital can take over the entire delivery of health care in the area," he said.

The alliance had sought a restraining order forcing ValleyCare to close its medical foundation clinic immediately, but an Alameda County judge denied its request Sept. 18, ordering the suit to go to trial.

For its part, ValleyCare denies an impropriety and said the accusations are just that--accusations.

"The lobbying organization sought to convince the court that the medical foundation was not operating in compliance with a statute that exempts the medical foundation from clinic licensure requirements as a clinic that contracts with a group of 40 or more physicians," ValleyCare spokeswoman Denise Bouillerce said in a statement.

Bouillerce said the medical foundation does comply -- its 41 doctors are associated with ValleyCare Physicians Associates, which is an independent medical group owned and controlled by physicians who practice in the Tri-Valley.

ValleyCare, a nonprofit health provider, has been operating in the region since 1961.

The Patient Physician's Alliance filed an amended complaint Tuesday to challenge the judge's ruling. A trial date has not been set.

ValleyCare Health System,Patient Physician's Alliance

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Like this comment
Posted by PElllis
a resident of Vineyard Avenue
on Oct 2, 2009 at 8:11 am

I've been aware of this problem for a couple of years now, but I didn't know there was an organization filing a suit... cheers!

I had already made up my mind to make some choices of health-care providers that are specifically outside of the Valley Care system. My husband has already done that and after some specific condition care is completed I'll be making the same move.

Please if possible fight monopolies, and fight for choices.

Like this comment
Posted by Christina
a resident of Birdland
on Oct 2, 2009 at 8:27 am

I love ValleyCare Medical Center and I think they provide excellent service and care for my family. This sounds like just one more frivolous lawsuit that takes focus away from the wonderful things ValleyCare brings to our community and puts it on doctors that can't keep their patients any other way.

Like this comment
Posted by Sue
a resident of another community
on Oct 2, 2009 at 8:35 am

I don't know about their hiring practice of doctors, but I do know the emergency room at the facility in Pleasanton is disgusting and FILTHY. It doesn't look like the floors have been mopped or cleaned since the facility opened. I brought someone into emergency the other day and looked around and walked outside to wait it was so FILTHY. The little time I did wait in the waiting room, the clerk at the desk was so rude to people that walked up and even called on the phone. Conversations are supposed to be confidential, however this gal spoke so loud they could have heard what she said at Trader Joes 3 blocks away.

Would I go there again? I don't think so.

Like this comment
Posted by resident
a resident of Birdland
on Oct 2, 2009 at 8:43 am

This isn't a patient rights group, but an organization of Doctors who are concerned about the competition from other qualified Doctors. The name "Patient rights" is deceiving. It is instead a mean spirited attempt to stop some of the best Doctors in our Valley from being successful. Medical groups are the only way to survive the high cost of health care because Medical groups share costs and revenue. Many other businesses do this. In Medicine it is becoming the norm not the exception. Palo Alto Medical Group, Stanford Medical Group, Kaiser for those who use Kaiser, etc... The bigger issue for valley residents is the survival of our local hospital. If you want the hospital to survive so that you have a local emergency room, use the hospital. Make sure that you select doctors that use the hospital. Businesses that aren't used can't survive. Support the Doctors that use our local hospital, Valleycare.

Like this comment
Posted by Peter M.
a resident of Valley Trails
on Oct 2, 2009 at 8:51 am

Valley provides the BEST care to their patients. I know this because they cared for me in emergency twice, my wife twice and my childeren. We have lived in this community for 37 years and can think of no one who would say that the facilities are not clean and the doctors and staff were not professional. Thank GOD for their being here to serve our community.

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Posted by Pleasanton Parent
a resident of Pleasanton Meadows
on Oct 2, 2009 at 9:10 am

"The Patient Physician Alliance, which bills itself as a grassroots organization based in Berkeley..."

I stopped reading after that....

Like this comment
Posted by What about Livermore?
a resident of Livermore
on Oct 2, 2009 at 9:35 am

Not sure how far you can trust ValleyCare.
Worthy Cause?
They started in Livermore as a Non Profit, and many good citizens, volunteers and groups helped keep it get established and keep it running. They even have a "charity" donated goods store.

But without notice or changing the name "Hospital" in big letters, they abandoned the community. In place of the Emergency Room, they had second rate doctors and medical trainees. Unfortunately, I took my aged mother to the "Hospital" when she broke her leg and all they did was give her a pain shot and a splint that was too big, and awkwardly helped her back into my car. They did not set the leg, or anything. But they did send a huge bill.
It looks like they just want to take money from Livermore residents - they now have a very costly exercise club there. When will they restore the Emergency Room and other Hospital services?

Like this comment
Posted by Parent
a resident of Lydiksen Elementary School
on Oct 2, 2009 at 2:21 pm

Everyone wants ValleyCare to survive and do well... but what the hospital administration is doing is wrong.

They are giving some selected doctors significant financial benefits, for becoming essentially employees of the hospital. These patients are then directed at specific labs, and other doctors. They are trying to make a "mini-Kaiser".

If you want to be limited to the doctors you see, or the time you have to see the doctors, or the place for your tests, this is what their medical foundation is offering.

Support doctors in Pleasanton, but if you have a PPO insurance and have a choice, keep your choice by chosing a doctor not in this "Foundation".

Like this comment
Posted by Charitable Foundation
a resident of Avila
on Oct 2, 2009 at 2:23 pm

Apparently now they have created a Charitable Medical Foundation that gets tax breaks and can accept donations like the Red Cross. Exactly what Charity has this Valley Care Foundation done for our community.

Like this comment
Posted by Birdie
a resident of Golden Eagle
on Oct 2, 2009 at 3:35 pm

I would rather have ValleyCare than Kaiser.

Why doesn't somebody sue Kaiser? Look at all the patients that they have put in harms way or have died because of unnecessary procedures of were given the wrong medications. I was almost a Kaiser stat. Until I went to Valleycare and they took care of me and got me healthy.

Like this comment
Posted by Kaiser is not an Illegal foundation
a resident of Another Pleasanton neighborhood
on Oct 2, 2009 at 4:05 pm

My understanding is that Kaiser, Palo Alto Medical Foundation, Stanford Medical all have legal foundations with more than 40 doctors.

Like this comment
Posted by Glad to have this discussion
a resident of Another Pleasanton neighborhood
on Oct 2, 2009 at 5:46 pm

I've been talking about health care for years. This is good stuff, hope people are thinking and listening...

PEllis--first post:
"Monopoly"? There are 41 doctors in the group out of hundreds who practice at ValleyCare. They were all offered the opportunity to join. If your doctor didn't, that's their right, but they weren't excluded.

resident of birdland:
absolutely right. It's got nothing to do with "Patients". The patient part is the doctors who are suing are handing their patients a paper and say "sign this, it will help your care" and offering them money off their bills if they do. These are doctors who chose not to join, and now are trying to sabotage the group. Meanwhile, hundreds of thousands of dollars, that should be going into paying salaries, buying new equipment, etc, will now be going in Mr. Bond's pocket, as well as the attorneys for the hospital that need to fight the charges.

What about Livermore?--
with all due respect, and I hope your mom is ok, Livermore was not "abandoned". The new hospital in Pleasanton was built to serve the whole area. It is 7 miles from the Livermore site. People drive further than that to get a meal. It has been widely reported and advertised that there is only an Urgent care in Livermore. Not every city has a hospital. And in fact, the ValleyCare ER has great ratings, though has been too small for years. It's finally being built up. But if you have a heart problem, they have great outcomes. And the new gym helps to support the hospital's other services that are not reimbursed.

Valleycare sustains millions per year in bad debt, not to mention charity care that is provided. If you want to spend some energy on the ills of health care in our community, speak to your doctor who refers you to lab, xray, MRI, and therapy in their own building, especially if you have a good insurance. Ask them if they take the Medi-Cal, Medicare, and community indigents that the hospital cares for.

That's it, I'm done....for now.

Like this comment
Posted by Thomas L.
a resident of Country Fair
on Oct 2, 2009 at 6:00 pm

Please make sure to ask your doctor ......"who are you working for?"
It is very important questions for all of us since we put our trust in our physicians who, we thought, will refer to "the best suited specialists and facilities" to solve our problems. But if your doctor is a contracted employee of one particular foundation, his/her best interest may not be you. The foundation or administration direct doctors where they should send their patients to and whom they should refer to so that the foundation is making more money.
ValleyCare foundation has limited specialist in the group and they keep referring the only one surgeon to me and I found out that that surgeon has no experience in my particular condition of thyroid operation. I will never go back to doctors from ValleyCare foundation.

Like this comment
Posted by Matt
a resident of Livermore
on Oct 2, 2009 at 7:19 pm

I like the facility and the staff. It looks like another law suite that should have been avoided!! To bad for the hard working doctors and staff that have to go through this. Good luck to you.
Mr. Bond and his group of representatives should go chase ambulances somewhere else!!

Like this comment
Posted by Katherine
a resident of Bonde Ranch
on Oct 2, 2009 at 7:57 pm

Web Link

Nonprofit hospitals taking the tax exempt status and giving to the extremely high salary for CEO.

I also heard that Hospital is using income from non-profit hospital to support this new physician employee group (for-profit organization) to compete the community independent physicians.

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Posted by M
a resident of Vintage Hills
on Oct 2, 2009 at 8:28 pm

Dear Glad to have this discussion: You are grossly mistaken-- NOT ALL physician's were invited to join the foundation. A select group of physicians in a limited # of specialties were. OF COURSE the physicians who remain in private practice are going to voice their concern against the Foundation and the illegal base that they established themselves on. It is WAY more political than this article even dare to describe, and given that, don't believe it's only the Foundation that has the best interest of patients in mind.

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Posted by Thomas L.
a resident of Country Fair
on Oct 2, 2009 at 8:52 pm

Thanks Katherine for web link about valleycare CEO salary which is the shocking high compared to the other much bigger east-bay hospital CEOs' salary.

No wonder the bills from my lab test and MRI at valleycare are much higher than outside facilities such as Qwest or NorCal.

If you have high deductible insurance plan or self-pay, ask your doctor or valleycare hospital about charges about the tests and shop around the outside facilites and you will see Valleycare is at least 3 or 8 times higher than outside facility. Now I know where those money goes to.


Like this comment
Posted by Pleasnton Resident
a resident of Kottinger Ranch
on Oct 2, 2009 at 9:02 pm

I am a long time resident of Pleasanton. I have also used Valleycare’s ER once as well as their Lab. More importantly my doctor’s office is right by the hospital. So when I heard about this lawsuit, I was very concerned and didn’t believe Valleycare hospital would illegally start hiring doctors and drive independent physician out of town. I decided to do my own investigation. So I called the foundation phone number and Valleycare’s public relations. On one line, I left a message and never got a call back. On the other, I got someone that refused to tell me who is in the foundation by saying “we can’t give that information out” Now, I am not a lawyer, but if this was a legal foundation, why would they be afraid of telling patients who is in their network? Please call and find out for yourself ((925) 373-4563). We pay extra for our PPO insurance to have the choice to see the best doctors. So I certainly don’t want a hospital administrator to limit my medical care for financial reasons. For those that don’t care, might as well join Kaiser and save yourself a lot of money. For the rest of us who value having a choice, I say lets all stand with doctors who are not hired by the hospital and practice independently. Thankfully my primary doctor is not in the foundation, is yours? Ask next time you are in the office and know your rights.

Like this comment
Posted by Ken Lamson
a resident of Livermore
on Oct 3, 2009 at 1:39 am

I have lived in Livermore for 37 years. We use to have a hospital in Livermore. No more, only Valley Medical "Club-Med" an expensive exercise guy run by the Valley Care, at what was the original Livermore Hospital site. No hospital any more, Valley Care tricked the residents with deceit and slick bias campain to make us think things would be better at the Livermore Hospital site, while they secretly were planning to all along to move the hospital out of town to Pleasanton. They did just than..... and now we no longer have a hospital in Livermore. Sad... sad... sad.

Like this comment
Posted by Dublin resident
a resident of Dublin
on Oct 3, 2009 at 8:48 am

It seems pretty simple to me. Let's have this Valleycare foundation list it's members so we can count them. If the have 41 doctors then shame on Charles bond if they have less than 40 then shame on the hospital. Let's keep it simple I have three children even though they play with 38 other children I still have only 3 children. So let's only list the doctors that are paid employes of the foundation. I really want to know who all these great doctors are.

Like this comment
Posted by Claudette McDermott
a resident of Another Pleasanton neighborhood
on Oct 5, 2009 at 1:51 pm

This is interesting, as I had to go to the Valley Care Hospital Emergency, requested by my doctor of the Palo Alto Medical Foundation when lab tests came back an hour later. I don't believe my doctor, was part of the Valley Care Hospital system, but game me the choice as it was closest to me. I had hoped that I would be seeing my doctor there at the hospital and was shocked when someone else was sent, unknown to me Dr. Joe Shmoe... who billed a rediculous amount to draw me a diagram and tell me what my own doctor would have told me. The Difference? My Doctor knows me and my complete medical background even stuff they don't put on your charts. Doctor Patient Trust and relationships are extreamly important. The hospital selected doctor, was nice, compitent... requeste a follow up. I declined a Follow Up with him and simply stated thanks but "No Thanks" I'm going to my own doctor.

We do have choices many don't realize they can voice and demand. If you are in an emergency situation, I would suggest just pray and hope for the best, as most doctors Do have your Best Interests at heart. No one wants to Lose a Patient :) I want Vally Care Hospital and Emergency Room to stay close to where we are living, just in case another Emergency pops up :) Some Help is better than No Help. A Long drive at an Emotional Time when minutes count will be what we are left with if Valley Care is closed.

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Posted by outside physician
a resident of another community
on Oct 21, 2009 at 11:21 pm

I am a physician with specific insight into "foundations" and Medical groups as I am a part of one. First of all, many of you are correct in supporting your local community based hospital. Many hospitals just like Valleycare are simply going out of business (i.e. case in point - your beloved Livermore hospital). I have no doubt, Valleycare has decided that to protect it's own viability it HAD to form a Medical Foundation and recruit physicians. Physicians are the life-blood of any hospital because they bring it business, inpatients and more importantly - surgical procedures as these turn the highest rate of profit.

Some of you expressed concern that community hospitals and their CEO's are greedy institutions - collecting high salaries - overcharging you for ER visits, hospital stays and even lab tests. You simply don't understand hospitals. For every paying patient, there are 2 or 3 who have NO insurance and the hospital eats the cost. If you have a business selling, lets say, cell phones and 2 out of every 3 phones you had to give away free. Then the 3rd phone, the one you actually sold, would have to be 3x as expensive. (on a side note Why is Kaiser to cheap - They have as few Emergency rooms as possible so that non-Kaiser patients can't get into their hospitals!!)

CEO's BTW are paid for their expertise. You can't hire a garbage man to run your hospital. You can't ask a lawyer, a construction worker, a maintenance guy to do it either. Having worked with 4 hospital CEO's I understand what they do and it takes a high level of proficiency and education to turn a profit, meet all of JCAHO and CMS's requirements, heal patients and provide good medicine.

So Why set up a foundation and medical group? Competition is fierce. Kaiser has about 35-40% of the market in pleasanton (roughly, though this has been shrinking as of late). PAMF has expanded and is now well established in Dublin. Hills Physicians is a very strong player in the area and uses the hospital for it's HMO patients. Kaiser keeps their patients in their hospitals. PAMF usually sends their patients to PAMF specialists and AWAY from Valleycare specialists (PAMF specialists are excellent, work out of the Stanford hospitals and are often associate professors at Stanford). Hills? I don't know if they are in some way affiliated with Valleycare's foundation or medical group. But since they stretch far and wide as an IPA and loose conglomeration of physicians and specialists, some of those referrals may be going elsewhere as well.

Did Valleycare med foundation ask all local community doctors to join? If they did, they'd be crazy. Many physicians are not "group material". Not all physicians play well with others. Valleycare would have likely only invited a select number of physicians.

Is that Illegal or a monopoly? No. Does it limit Choice of Physicians? Yes. But only if you have an HMO that contracts with Valleycare and you choose a primary care physician in that medical group. PPO patients can travel in and out of the medical group as they please.

Why a lawsuit? Often these are brought by the "outside physicians" or "community physicians" utilizing a patient advocacy group. Physicians are often fractionated and divisive when it comes to business. We'd often remove our fellow doctors eyebrows with a blow torch if we don't agree with their business practices. Why? Because we all think we're competing for the same pool of patients. the community physicians are afraid the foundations and med group will be successful, pull patients away from them. In my opinion, the hospital has taken a HUGE risk by fracturing the medical community to preserve it's own supply line of patients from it's own medical group. If they keep expanding and offer quality doctors who perform quality work, the hospital will survive and even thrive. The competition will actually improve the level of care of your local physicians as they have to compete. And, you the consumer get more choice in the long run.

The final reality is: The community needs the hospital to remain viable and alive because when you are having that stroke, driving the extra 25 minutes to Eden or John Muir is a death sentence.

Like this comment
Posted by Indendant doc
a resident of Another Pleasanton neighborhood
on Jan 15, 2010 at 12:45 pm

Claudette McDermott, you are right to stick with the physician who knows you. It is actually considered an ethics violation by the California Medical Board if a physician attempts to refer you away from another physician (such as a specialist)that you currently see without your express consent.

It is a major ethics violation if they are trying to replace your previous physician with themselves.

I commonly cover for other doctors in the area and do Pre-Op physicals for patients who have a physician who doesn't have priviledges at the hospitals where I work.

I ALWAYS make it a point to say, "Follow up with Dr. ____ (their current physician)" if things don't get better or it they have issues that need follow up. IF the patient specifically ask ME if they can follow up with me, I let them know that it is their right to see whoever they want, but that they can follow up with either of us and that I'll send any information about their visit to their current physician.

These physicians should not be soliciting you when they know that you already see another physician. The California Medical Board takes such things very poorly.

If you are interested in whether this case is illegal or not, the date I've seen in other Valley Newspapers for the hospital to ask for this case to be dismissed is today. I guess that we'll see if this is an greedy hospital or disgruntled non-competitive doctors.

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Posted by outside physician
a resident of Livermore
on Feb 15, 2010 at 11:56 pm

For everyones information who cares about this topic, the "foundation" has not invited all the physicians in the are to join. There are quite a few who were not invited for political rather than medical reasons. It is unfortunate that a system like this has enough power to make sure that nobody speaks up against them; Those who dare will face horrible consequences for ever attempting to let the truth be know. I can say without doubt that the "Foundation" is
a self-serving entity, and should not be confused with the many well meaning physicians who have taken care if patients in the area for decades. Don't let names fool you!

Like this comment
Posted by Physician
a resident of Another Pleasanton neighborhood
on Feb 26, 2011 at 10:56 am

(Post removed by Pleasanton Weekly Online staff as innuendo, hearsay or specific accusatory information unsupported by facts.)

Sorry, but further commenting on this topic has been closed.

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