To make more money, IU Health pressured doctors to limit time with patients, lawsuit says

Update: This article was updated May 18 with comment from IU Health. 

The conflict between a long-time IU Health doctor and his former employer has spilled into the public with a lawsuit claiming the state’s largest health care system pressured physicians to spend less time with patients to increase revenues. 

Brian Leon, 57, began working as a doctor at IU Health and as a faculty member at the IU School of Medicine in 1997, according to the lawsuit. He was the site medical director at IU Health’s University primary care facility at 550 North University Blvd. before he was selected to be one of the five primary care regional medical directors in 2018. 

Two years later, and despite Leon's pleas for negotiation, they stripped him of that title. Now he is suing.

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In a legal complaint against the health care provider that was transferred Friday from Marion County court to the U.S. District Court for the Southern District of Indiana, Leon claims IU Health violated his contract partially because they didn't follow its rules around terminations.

He also claims IU Health's primary care leadership established for physicians a goal of “ten minutes per patient per visit” as a means to increase revenues following a two-year financial downturn. Leon says he pushed back on the timeframe, calling it "woefully inadequate and inappropriate for his patients’ highly complex illnesses."

Leon claims economic losses suffered by the health care provider between 2016 to 2018 laid the groundwork for the "ten minute" goal. The lawsuit says IU Health experienced deficits of more than $200 million during each of those three years.

As a result, leadership pressured physicians to spend less time with their patients, less time reviewing their cases and lab histories and less time taking notes after an appointment, the lawsuit claims. Leadership also urged physicians to "see as many patients as possible per four-hour session," according to the complaint.

IU Health responds

IU Health has not yet filed a response to the claims in court.

A spokesperson for IU Health told IndyStar the lawsuit's description of a 10-minute limit on patient visits is incorrect. The lawsuit states physicians were encouraged to limit "Electronic Medical Record time," including "visiting with a patient in person, by phone or virtually," but spokesperson Jeff Swiatek said that's a mischaracterization. 

"While IU Health cannot comment on active litigation, IU Health can confirm there is no directive to limit patient appointments to I0 minutes," the statement reads.

"The 10-minute reference in the legal document refers to time spent in the electronic medical record (EMR) documenting information, typically after the patient visit. The EMR time does not include the time a physician spends directly with the patient (listening, diagnosing, treating them)."

In his lawsuit, Leon says the time limit was inconsistent with IU Health's primary care directives, as well as the Hippocratic Oath and common practice by internal medicine doctors like Leon, all of which support a practice of scheduling 20- to 30-minute return visits and 40- to 60-minute new visits with patients.  

After he pushed back against the "ten minute" goal, Leon claims in his lawsuit IU Health's primary care leadership told him to keep silent and do what he was told.  

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Replaced by less-experienced doctor

He says IU Health’s primary care leaders had a "personal animus" against him that was evidenced through disparaging statements and disregard for his comments on how to improve their practice.

Leon was relieved of the regional medical director role in April 2020 but allowed to continue working for IU Health as a physician, according to the lawsuit. There was no justifiable reason for that demotion, Leon claims.

The lawsuit says he was replaced by a younger, less-experienced physician as part of an "agenda" to replace qualified physicians with those who "were paid less" and "could increase (IU Health primary care's) revenues" through less time spent with patients. 

It is unclear from the complaint how many disparaging statements were made, and what those statements were. In one instance, it claims a letter prepared by IU Health that included his signature and gave an endorsement to the health care system’s primary care doctors was distributed to his patients without his approval, amounting to defamation.

The complaint does say his colleagues claimed he had "a prejudice against women employees," which Leon also says is defamatory. No one other than Indiana University Health Care Associates, Inc., is listed as a defendant.

Leon is now working for Community Health Network and remains an adjunct faculty member at IU School of Medicine. He is requesting financial compensation in the form of damages related to 19 claims against IU Health, including breach of contract, age discrimination, defamation and harassment. 

Call IndyStar courts reporter Johnny Magdaleno at 317-273-3188 or email him at jmagdaleno@indystar.com. Follow him on Twitter @IndyStarJohnny