A motion to dismiss a lawsuit alleging monopolistic business practices in concierge medicine was denied April 21 in U.S. District Court in Los Angeles.

In denying the motion, the court rejected MDVIP's concierge medicine network's assertion that competitor SignatureMD had failed to demonstrate predatory or anti-competitive conduct designed to establish a monopoly, according to a news release issued by SignatureMD.

The decision by Judge Dolly M. Gee could result in a trial that helps shape the future of the concierge medicine industry.

At the heart of the court dispute is SignatureMD's allegation that MDVIP has engaged in unenforceable non-compete clauses, sham litigation and threats of legal action against doctors that violate federal and state laws.

According to SignatureMD's complaint, in California MDVIP requires a large liquidated damages provision in the non-compete clause of its contracts with member physicians. This requires a California doctor to pay $1 million if he or she leaves the system to join a competing company.

MDVIP operates the largest concierge medicine membership program in the U.S. SignatureMD is the No. 3 player in the concierge medicine industry. SignatureMD says it has been having a hard time signing new doctors because of the overly restrictive contracts that MDVIP requires physicians to sign. It alleges these contracts have bound doctors to MDVIP until their retirement, even if they want to work with competing companies.

Concierge medicine is sometimes called "boutique medicine.” It seeks to create greater physician access, for which the patient typically pays an annual fee or retainer.

The fee typically ranges from $1,500 to $2,000 per patient per year, according to SignatureMD. In return for the fee, patients avoid the bureaucracy of the mainstream healthcare system. The goal is to create a connection between patient and doctor that leads to better care, advocates say.

According to an April 22 report in the Boston Globe, primary care doctors typically see thousands of patients a year, while concierge practices are limited to a few hundred patients. Supporters say concierge patients get more attention, longer appointments and more personalized care.

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