$300,000 in Legal Fees to Keep Seeing 200 Patients

Dr. Nyasha Spears has spent $300,000 on lawyers so she can keep taking care of about 200 patients in Duluth, Minnesota.

That is not a typo. That is the price of a noncompete.

She signed it in October 2013, when she joined St. Luke's P.S. Rudie Medical Clinic downtown. Standard language. No similar practice within 25 miles for up to 2 years after she left.

Then her employer closed the clinic. Aspirus St. Luke's gave the doctors 36 days of notice, according to court documents reported by the Duluth News Tribune. Their contracts required 180. The doctors asked to be released from the noncompete. Aspirus said no.

So Spears sued. In February, Judge Shawn Reed blocked Aspirus from enforcing the clause while the case goes on. He wrote that enforcing it would keep her from practicing in her own community and disrupt care for her patients. And in a state short on primary care doctors, it would "exacerbate an existing public health problem, in direct conflict with the public interest."

In April, she and Dr. Kristin Lusian opened Amity Creek Primary Care, a direct primary care practice in Duluth's Lakeside neighborhood. The prices are on the website. $40 a month for kids. $90 to $130 a month for adults, depending on age. Labs at wholesale. No insurance billed.

Spears told Star Tribune columnist Aaron Brown who walks in the door. Carpenters. Artists. Waitresses. Sandwich makers. People who own a welding company or a cleaning company. "These are people who are the backbone of America who cannot get health care."

Aspirus appealed. The appeals hearing was October 8. As I write this, I have not seen a ruling.

Here is the part that should bother everyone. Minnesota banned noncompetes in 2023. But the law only covers agreements signed on or after July 1, 2023. A doctor who signed in 2024 walks. A doctor who signed in 2013 litigates.

I am not shocked. A health system that closes the clinic is not protecting the clinic. It is protecting the territory. 200 patients is not a threat to a regional system. It is a neighborhood that finally has a doctor who answers.

A noncompete in medicine does not stop a doctor from competing. It stops patients from following the doctor they already trust. The patient never signed it. The patient pays for it anyway.

If you are an employed physician thinking about the jump, pull your contract tonight. Read the radius. Read the date. Read the notice clause. Then talk to a lawyer before you sign a lease.

In direct care, nobody owns the relationship but the patient and the doctor.

$300,000 is not the price of competition. It is the price of permission.