The court opinion stated that the ECP interfered with Arkansas public policy of protecting a patient's right to the physician of their choice. Public policy, the court said, also disfavors economic credentialing and suppression of competition. The court noted the ECP even interfered with marriage relationships, in that a physician practicing at Baptist whose spouse had a financial interest in another hospital would be faced with either the economic loss of privileges at Baptist, or coercing the spouse to give up the financial interest.

Baptist's justifications for the policy, including protecting patients from alleged conflict of interest, were determined by the court to be pretextual and not supported by evidence. Baptist's legal defenses included an argument that it had the right of refusal to deal-it could not be compelled to grant privileges, and another party could not compel it to contract. The court rejected this defense, saying that a party cannot refuse to deal where the refusal was unreasonable, unconscionable or contrary to public policy. Prior successful cases using the defense of refusal to deal were distinguished by the court because these cases were not, as here, concerning tortuous interference, interrupting an existing relationship, or involving physicians and medical care. The court granted both the declaratory judgment and the permanent injunction.


The AMA press release said the order was a "legal victory that preserves the patient-physician relationship and promotes competition." "Hospital admitting privileges have long been considered an indispensable component of a medical practice," said Rebecca Patchin, M.D., chair-elect of the AMA Board, in the AMA press release. "Baptist Health took advantage of this fact to coerce physicians and squash competition from other medical facilities."

"Patients benefit when their physicians have staff privileges at multiple facilities, because the patient has a choice of facilities to select from that best suits their needs in terms of costs, quality and convenience," said AMS President David Jacks, M.D. in the AMA press release.

"This important court victory demonstrates that economic policies that restrict physician credentialing are really intended to prevent patients from choosing medical facilities that might compete with large hospitals," Dr. Patchin was quoted. "Hospitals cannot use their financial interest to justify policies that interfere with patients' health care choices."

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