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In a lawsuit filed November 11, orthopedic surgeon Scott Duncan, MD, accused OrthoSC, a South Carolina-based orthopedic group, of intentionally sabotaging a residency program in the making in order to preserve its monopoly.

Along with OrthoSC, Myrtle Beach's Grand Strand Regional Medical Center (GSRMC), HCA Physician Services, and orthopedic surgeon Gene Massey, MD, were named as defendants in the complaint.

In the lawsuit, Duncan's attorneys wrote that HCA recruited him in 2017 when he was working as the chairman of the orthopedic surgery department at Boston University. During this hiring process, HCA specifically promised Duncan that he would be named the director of a graduate medical education (GME) program at GSRMC for at least 5 years starting in the summer of 2017, as part of his transition to Myrtle Beach, he alleged.

In recent years, HCA Healthcare has been making an effort to across specialties, declaring in a March report that nearly 2,000 residents and fellows were offered positions in their training programs that year.

Despite Duncan's desire to have Massey and other surgeons from OrthoSC join the program's faculty, he got the sense that they were not receptive to the idea. So, he began conducting interviews with other potential candidates, according to the lawsuit.

The CEO of GSRMC reportedly sent Massey an email, providing him with a deadline for when he could communicate his final decision as to whether or not he and OrthoSC surgeons would agree to serve as faculty members for the residency program.

After responding to this email with a request to extend the deadline, Massey allegedly sent an "intimidating" and "coercive" email to Hugh Tappan, the president of HCA Healthcare's South Atlantic division and the person in charge of GSRMC. In it, he threatened to pull all of OrthoSC's surgery cases from the hospital and transfer them to competing hospitals if they proceeded with their plans for the GME program.

According to the complaint, this threat was again reiterated by Massey in a subsequent phone call with Tappan; during this call, the lawsuit claimed that Massey told Tappan that OrthoSC's surgeons "'did not want to be training their competition' and that the GME program threatened Defendant OrthoSC's monopoly" in Myrtle Beach's orthopedic surgery market.

Duncan's lawsuit further charged that OrthoSC used its monopoly power to prevent other orthopedic surgeons from entering the market and providing services to the public -- ultimately harming the general public by "eliminating competition [and] reducing the availability and number of orthopedic surgeons" in the region.

Because of these alleged threats, the complaint stated that HCA "immediately canceled, terminated, and repudiated the GME program despite their prior promises, representations, and assurances to [Duncan] that they would hire the necessary faculty" in the event that OrthoSC refused to participate.

Duncan accused HCA of wrongfully terminating his employment contract in April and revoking his hospital privileges without explanation as a direct result of Massey's threats to GSRMC. He is suing HCA for breach of contract; failing to pay him his promised compensation, including his base annual salary; and for violating the South Carolina Payment of Wages Act. Duncan and his attorneys are seeking a trial by jury, in addition to monetary damages, according to the lawsuit.

In a statement to local outlet , a representative for GSRMC said "it is aware of the lawsuit from a former employee and has no comment."

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