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November 2002 Home Poll Shows Continued Support for Academic Medicine NRMP Update: AAMC Seeks to Dismiss Suit; Some Groups Seek Arbitration Caring for the Underserved: The Art and Science of Community-Based Medicine Restoring the Balance: Fostering the Medical Education of Native American Students Physician Novelists: At the Intersection of Writing and Healing "A Day in the Life of a Medical Student" A Word From the President
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NRMP Update: AAMC Seeks to Dismiss Suit; Some Groups Seek ArbitrationThe AAMC filed a motion Sept. 9 asking to be dismissed from the lawsuit filed earlier this year by three former residents against the National Resident Matching Program (NRMP). The motion argues that the plaintiffs have failed to identify any unlawful conduct on the part of the AAMC, and specifically asserts that the association's publishing of the annual Survey of House-staff Stipends, Benefits and Funding, its status as a sponsor of the Match and of the Accreditation Council for Graduate Medical Education (ACGME), and its operation of the Match program for the NRMP do not constitute illegal activities, as the suit alleges. The NRMP, which is co-sponsored by the AAMC and several other organizations, filed a motion to dismiss the lawsuit and to compel arbitration - submitting the dispute to an impartial third party for resolution - of the plaintiffs' claims. This motion is predicated on participation agreements the plaintiffs signed before participating in the Match, stating that "all claims, disputes or other matters" related to the agreement or to the program must be resolved by "binding arbitration in accordance with the rules of the American Arbitration Association." Three other organizational defendants joined in the NRMP's motion. Nineteen of the 29 institutional defendants in the case filed an omnibus motion to have the complaint against them dismissed due to lack of personal jurisdiction. They reside outside of the District of Columbia, and argued that no relevant facts connect them to that district. The plaintiffs have asked the court to give them until Nov. 25 to respond to the defense motions. Filed May 7, the suit alleges the Match and certain other activities violate antitrust laws. Besides the NRMP, the suit targets the ACGME and the Match's five sponsors: the AAMC, the American Medical Association, the American Hospital Association, the American Board of Medical Specialties, and the Council of Medical Specialty Societies. The suit also names 29 hospitals and healthcare systems as co-defendants. It alleges defendants have engaged in an "illegal combination and conspiracy" to restrain competition in the employment of residents by "stabilizing wages below competitive levels through the exchange of competitively sensitive information," by "eliminating competition in the recruitment and employment of resident physicians through the NRMP," and by "establishing and complying with anticompetitive accreditation standards and requirements through the ACGME." The plaintiffs make three allegations regarding the AAMC, but do not state what the association is supposed to have done as part of the alleged antitrust conspiracy. The allegations state that the AAMC "manages and operates" the Match, is one of the sponsors of both the NRMP and the ACGME, and annually surveys its members regarding stipends and publishes the survey results.AAMC believes services are lawful"The AAMC has acted in an entirely lawful manner," says AAMC President Jordan J. Cohen, M.D. "The plaintiffs have failed to show anything illegal in our operation of the Match, in our sponsorship of the NRMP and the ACGME, or in our housestaff stipend survey." With respect to the AAMC, the plaintiffs' complaint focuses on the stipend survey. According to the plaintiffs, the association collects and disseminates information that "facilitates collusion among resident 'employers'" with respect to resident compensation. The plaintiffs do not allege, however, that the AAMC has conspired with teaching hospitals or anyone else to fix stipends paid to medical residents. The association denies there is anything illegal about its stipend survey, noting that the survey falls within the "safe harbor" guidelines issued by two federal agencies. It further maintains that it has simply engaged in constitutionally protected speech posing no restraint to trade. Citing case precedents, the AAMC asserts that, because the resident market is "unconcentrated" with more than 1,000 residency program sponsors dispersed throughout the country, it is unreasonable to suggest that institutions would fix resident stipends on the basis of the information contained in the housestaff survey. The AAMC also notes that differences in the educational quality of residency programs, the desirability of particular geographic regions, and the prestige of different institutions make "efforts to fix stipends based on an information exchange inherently implausible." Finally, the AAMC notes that the non-specificity of the housestaff survey data - the survey lists national average salaries for a number of years and does not identify particular employers - further refutes the claim that information in the survey can be used for anticompetitive purposes. "Plaintiffs have based their accusations of an antitrust violation by the AAMC on the fact that the association collects and publicly disseminates information that is non-specific to individual residency programs, and does not include future compensation information," says Dr. Cohen. "Because the type of information our survey publishes is absolutely legal, and because the AAMC did not in any way encourage program directors or anyone else to use the data for anticompetitive or unlawful purposes, we believe the case against us should be dismissed."
- Suria Santana, ssantana@aamc.org |
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