This month, New Hampshire Gov. Maggie Hassan signed SB417 into law. I had the opportunity to testify in support of this bill at both State House and Senate Committee meetings. This Bill will prohibit certain restrictive covenants or non-competes in physician employment contracts. These restrictions prevent physicians from practicing medicine in the geographic vicinity of a former employer, typically for 1-2 years following termination of an employment relationship. However, these restrictions do not simply prevent one Doctor from practicing medicine in a region. The net effect is that they deprive thousands of patients of the prerogative to receive medical care from the Doctor of their choice, thus destroying the most sacrosanct foundation of medical practice, the Doctor-Patient relationship.
My testimony as a Family Physician was of a personal nature, to underscore the significance of this relationship. I was recently able to exit an existing employment contract without restrictions, and open a Direct Primary Care Practice to better serve my patients. The family of a very dear patient, whose photo accompanies this post, gave me permission to share the story of how we navigated this transition. It was warmly received by our State Legislators as a poignant example of how the Doctor-Patient relationship, recognized as integral to the practice of Medicine since the time of Hippocrates, transcends any Physician-Employer contract.
One Patient’s Story:
I first met Mr. C six years ago when he was 94 years old. We grew to know one another well as I saw him regularly in the office, each time accompanied by his three doting daughters. I was there for him through multiple hospitalizations, a stroke, heart surgery and even the onset of a mild dementia. When I informed him last fall of my plans to leave my former practice, he said quite plainly, “You ain’t running away. You’re my doctor. I’m going with you. I ain’t going to nobody else.”
And indeed, he did. I was there for him last month, when his condition deteriorated. He, his family and I understood implicitly how best to care for him. When he became too weak to come into the office, I visited him in his home. He no longer wanted to talk about symptoms, or medications, or prognosis. He wanted to show me the pictures on his wall, the bedside table he built himself and a treasured carved shell that he carried home from Italy after WWII. He told me the story of this photograph, taken on a muddy hilltop in Belgium in December of 1944. Those who know their history will recognize the significance of that date. It was the day before his platoon was attacked and fought through the Battle of the Bulge. He told me about his own father who was killed in WWI by the Germans. This had fueled his desire to fight in the war. He shared, however, that after killing a few enemy soldiers, he didn’t want to do it anymore. He would capture them instead, and turn them in to his commander. “They were just like us,” he said. “Scared kids.”
Well, I believe that in the end, Mr. C was no longer afraid. He had the support of his family, his hospice nurses, and his Doctor. Two days after my visit, he died peacefully at home, at the age of 100. It would have been a real tragedy if I had been forced to abandon this decorated war hero in his last months of life because of a non-compete clause. I am grateful that our lawmakers had the vision and fortitude to pass SB417, to help preserve the sanctity of the Doctor-Patient Relationship.