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Emergency medicine physician Raymond Brovont, MD, will against the physician staffing company EmCare, according to NPR's Kansas City affiliate.

In 2018, Brovont filed a suit claiming he was fired after raising concerns about staffing issues at Overland Park Regional Medical Center in Kansas. Brovont repeatedly sounded the alarm that EmCare staffed only one physician on the night shift to cover both the regular and the pediatric emergency department at the hospital, which is owned by HCA Healthcare.

A , which included almost $3 million in economic damages, $6 million in pain and suffering, and $10 million in punitive damages against each of the defendants, KS-I Medical Services and MO-I Medical Services (both are EmCare subsidiaries, the former in Kansas and the other in neighboring Missouri).

A trial judge subsequently reduced the award to $13 million after applying punitive damages caps under Kansas law, but both sides filed an appeal; for Brovont, the argument was that Kansas law should not apply because the staffing company is based in Missouri, which has no caps. The Missouri Court of Appeals ultimately ruled in the doctor's favor, though the original award was reduced to $23 million, increasing to $26 million with interest.

When the Missouri Supreme Court recently refused to review the case, the $26 million award stood.

Brovont's lawyer Michael Ketchmark of the Kansas City law firm Ketchmark and McCreight told MedPage Today that his client has never agreed to interviews, and did not comment further. Envision Physician Services, which owns EmCare, did not return a request for comment as of press time.

EmCare was founded in Dallas in 1972 and provides physician staffing services through more than 1,000 contracts with hospitals in 42 states. Parent company Envision has been ," saddling patients with huge out-of-network charges.

Contract management groups (CMGs) in emergency medicine have come under scrutiny in recent years over questions as to whether they best serve both the physicians they hire and the patients those doctors care for. CMGs provide billing and coding services, but often at the expense of physician autonomy, .

"The business model used by these contract management groups is the same one as McDonald's: use the cheapest labor possible to churn out a mediocre hamburger," said Mitchell Li, MD, an emergency physician in Chicago. "Expertise is seen as a line item expense only and patient safety takes a distant backseat to investor profit."

"Private equity, and, frankly, lay ownership, has no place in medicine," Li told MedPage Today. "Judgments such as this should empower physicians everywhere to speak up against injustices that they endure on a regular basis."

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