A Florida surgeon claiming he was fired for refusing to refer patients only to in-network medical facilities has shifted legal tactics, now suing his former employer in state court.
In January, orthopedic surgeon Ayman Daouk, MD, sued Orlando Health and two of its subsidiaries -- Physician Associates, LLC and the Orlando Health Physician Group -- for whistleblower retaliation, claiming that the organization unlawfully terminated his employment after he performed surgeries at out-of-network hospitals.
Daouk dropped that suit in June when the U.S. Department of Justice declined to join the case. Now , this one in a Florida state court, featuring basically the same charges. Daouk claims damages including loss of pay and benefits, loss of dignity, and emotional anguish and distress.
In both suits, Daouk accused the health system of barring him and other doctors from practicing at hospitals outside the health network or referring patients to out-of-network facilities, and said he was fired for his refusal to comply. The mandate for in-network referrals was a violation of "Stark Law" and anti-kickback statutes, Daouk asserted.
Because Orlando Health owns the facilities to which it requires physicians to refer patients, "there exists an unbroken chain of financial relationships that renders these referrals as violations of the Stark Law," according to the latest suit.
Hospital administrators terminated Daouk's employment in 2018 after he objected to demands that he stop performing surgeries at Florida Hospital, an out-of-network facility, the current complaint alleges. Since 2014, officials repeatedly asked Daouk to stop treating patients at this hospital. Dan Buhring, president of Physician Associates LLC, allegedly told the surgeon that by performing surgeries at other hospitals, he was "send[ing] a very negative message to your employer."
Daouk said that operating at Florida Hospital was convenient for his patients and allowed him to provide high-quality care, as he had access to specialized materials needed for orthopedic surgeries, such as specific plates, screws, and grafts.
In addition, the surgeon was repeatedly asked to refer more patients to radiologists within the Orlando Health system, although his patients complained of unnecessary delays and long wait times. Buhring allegedly told him that his "lack of support" for in-network clinics was being discussed throughout the system.
"You're going to want a favor at some point, and your lack of support is going to hurt you someday," Buhring allegedly wrote in an email. "I'm sorry to be so bold, but you have to know this."
A spokesperson for Orlando Health said the organization can't comment on pending litigation. Neither Daouk nor his attorneys would provide comment.