AMERICAN ANESTHESIOLOGY OF GEORGIA, LLC v. NORTHSIDE HOSPITAL, INC. D/B/A NORTHSIDE HOSPITAL GWINNETT

Court of Appeals of Georgia·Decided December 29, 2021·No. A21A1644·Published

Opinion

FIFTH DIVISION

RICKMAN, C. J.,

MCFADDEN, P. J., and SENIOR APPELLATE JUDGE PHIPPS

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December 29, 2021

In the Court of Appeals of Georgia A21A1644. AMERICAN ANESTHESIOLOGY OF GEORGIA, LLC v. NORTHSIDE HOSPITAL, INC.

PHIPPS, Senior Appellate Judge.

In this action for a declaratory judgment concerning the enforceability of restrictive covenants, defendant American Anesthesiology of Georgia, LLC (“AAG”) appeals from the trial court’s order granting the plaintiff’s motion for a judgment on the pleadings as to Counts One and Two of its complaint.1 AAG contends that the trial court erred when it ruled that the restrictive covenants at issue here are unenforceable. For the reasons that follow, we agree and reverse.

1 Although the trial court’s order addressed only Counts One and Two of the plaintiff’s three-count complaint, the court expressly directed the entry of a final judgment and determined that there is no just reason for delay as to its rulings on Counts One and Two. See OCGA § 9-11-54 (b).

AAG is the successor-in-interest to Gwinnett Anesthesia Services, P.C., while plaintiff Northside Hospital, Inc. d/b/a Northside Hospital Gwinnett and Northside Hospital Duluth is the successor-in-interest to Gwinnett Hospital System, Inc. For purposes of this appeal, AAG and its predecessors will be referred to collectively as “AAG,” and Northside Hospital and its predecessors will be referred to collectively as “Northside.”

At issue in this appeal is a 2003 “Professional Services Agreement for Anesthesia and Pain Management Services” (the “Services Agreement” or “Agreement”) entered into between AAG and Northside. Under the Services Agreement, AAG agreed to provide Northside with the services of anesthesiologists (designated as “Specialists” in the Agreement) and physician assistants, certified registered nurse anesthetists, and other advanced practice nurses and nurse clinicians engaged in the specialty of anesthesiology (collectively designated as “Physician Extenders” in the Agreement) during the initial term and any renewal term of the Agreement. In return, Northside agreed to grant AAG the exclusive right to perform the services rendered by the Specialists and Physician Extenders for Northside’s patients while the Agreement remained in effect.

By its express terms, the Services Agreement did not establish an employer-

employee relationship between Northside (defined in the Agreement as the “System”) and either AAG (defined as the “Practice”) or its Specialists or Physician Extenders. In that regard, the Services Agreement states:

The relation of the Practice, the Specialists, and the Physician Extenders with the System shall be that of independent contractors practicing their respective professions as medical specialists, and the Practice, the Specialists, and the Physician Extenders will at all times be considered independent contractors and not employees, agents or partners of the System.

The Services Agreement provisions primarily at issue in this appeal appear in Sections 9 (a) (“Offers by the Practice”), 9 (b) (“Offers by the System”), and 15 (c) (“Non-competition and Non-solicitation Covenants”). Section 9 (b) — the enforceability of which is at issue here — provides, in relevant part:

Recognizing the special nature of the relationship existing, or that will exist, between the Practice and the Specialists and Physician Extenders whom it employs or retains in the Practice, and that the recruiting and training of Specialists and Physician Extenders by the Practice is a costly and time consuming endeavor, the System agrees that it will not, without the written consent of the Practice, [while the Agreement is in effect and for one year after its termination], directly or indirectly, through any manner or means, impair or initiate any attempt to impair

the relationship which exists between the Practice and any Specialists or Physician Extenders through offers of employment or offers of contracts for services to be rendered by such Specialists or Physician Extenders or otherwise.

The parties refer to the above provision as the “no-impairment clause.” Section 9 (b) further provides that, while the Agreement is in effect and for one year after its termination, Northside “will not employ or contract with or otherwise permit any Physician Extender to provide services at the Hospitals[2] without the prior written consent of the Practice.” The parties refer to this provision as the “no-hire clause.”

Section 9 (a) similarly provides, in relevant part:

Recognizing the special nature of the relationship existing, or that will exist, between the System and the Department Personnel whom it employs or retains in the Department,[3] and that the recruiting and training of Department Personnel for the Department by the System is a costly and time consuming endeavor, the Practice agrees that it will not, without the written consent of the Hospital, [while the Agreement

2 The Services Agreement defines “Hospitals” as several specifically identified medical facilities “and any other facility which is now or in the future may be owned or operated by [Northside], or any affiliate thereof.”

3 In relevant part, the Services Agreement defines (i) “Department” as “the Anesthesia Department and Pain Management Service of [Northside]”; and (ii) “Department Personnel” as “the non-physician . . . personnel employed by [Northside] and assigned to perform services or functions for the Department.”

is in effect and for one year after its termination], directly or indirectly, through any manner or means, impair or initiate any attempt to impair the relationship which exists between the System and any Department Personnel through offers of employment or offers of contracts for services to be rendered by such Department Personnel or otherwise.

A related provision, Section 15 (c), in turn, provides:

Non-competition and Non-solicitation Covenants. The Practice covenants and agrees that [while the Agreement is in effect and for one year after its termination] by the System with cause or by the Practice without cause, the Practice shall not, on its own behalf or on behalf of any person[ or entity] (“Person”):

(i) engage in the practice of professional anesthesiology services within the Service Area [defined as “Gwinnett County, Georgia”]

(except with respect to those obligations to which the System has expressly consented in writing . . .). The Practice acknowledges and agrees that: (A) this covenant is intended to protect the investment the System has made and will continue to make in establishing the Department, the role of the Practice and the Specialists in the Department[ and] the System, and (B) the restrictions contained herein are reasonable in terms of duration, scope and geographic area; [or]

(ii) solicit, recruit, or induce any employee or independent contractor of the System who is actively employed or otherwise engaged by [the] System and who was employed by or otherwise

engaged by [the] System at any time during the initial term or any renewal term of this Agreement to sever his or her relationship with [the] System or to be employed or otherwise engaged in any capacity by any other Person conducting a business of practicing medicine.

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AMERICAN ANESTHESIOLOGY OF GEORGIA, LLC v. NORTHSIDE HOSPITAL, INC. D/B/A NORTHSIDE HOSPITAL GWINNETT, (Ga. Ct. App. 2021).

AMERICAN ANESTHESIOLOGY OF GEORGIA, LLC v. NORTHSIDE HOSPITAL, INC. D/B/A NORTHSIDE HOSPITAL GWINNETT (AMERICAN ANESTHESIOLOGY OF GEORGIA, LLC v. NORTHSIDE HOSPITAL, INC. D/B/A NORTHSIDE HOSPITAL GWINNETT) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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