HELENA - When Helena physician Elaine Samuel decided to leave St. Peter's Hospital last year to work for the Veterans' Administration health center in town, the hospital said she had violated a competition provision in her contract and owed the hospital at least $75,000.

Samuel sued the hospital, saying the non-compete provision is invalid.

The contract language "restricts access to medical care … by forcing qualified and competent doctors to leave Helena if they leave St. Peter's Hospital," and should be struck down, her attorney wrote.

Samuel's case, now awaiting a decision from District Judge Kathy Seeley of Helena, is among a handful of recent legal battles in Montana involving doctors who leave a hospital or clinic and want to keep practicing in the same town.

Their former employer tries to stop them or seek damages, saying the physician signed a contract barring him or her from competing with the former employer under certain circumstances.

Hospitals that require these contracts say it's simply a means of protecting their substantial investment in bringing a doctor to town.

Recruiting costs, salary guarantees and other expenses can total $250,000 for the first year of employing that physician, and hospitals shouldn't have to eat all of those costs if the person ends up working elsewhere, said John Solheim, president and chief executive officer at St. Peter's Hospital.

"The community has invested a lot of money in those physicians," he said. "For them to just be able to move to another organization without those sunk costs, we want some sort of coverage to recoup that, so it makes it fair."

Physicians at the other end of these disputes said it can harm access to health care, because the contract restrictions can force doctors to leave a community where they'd like to stay and keep providing care.

"It prevents continuity of care for patients," said Dr. Michelle Corbin of Deer Lodge, who just settled a dispute with Powell County Medical Center, which had sought to prevent her from practicing in town after her employment contract at the hospital was terminated in May. "If I wasn't allowed to stay, all of these patients would have had to find a new doctor, and re-establish a new relationship. That's very frustrating if you have to do that every few years."

Corbin's settlement, reached two weeks ago, allowed her to open a clinic in Deer Lodge and maintain practice privileges at the hospital.

Whether such contracts can be enforced in Montana may be in doubt, in the wake of a court decision in a Great Falls case, said Bob Olsen, vice president of MHA, a hospitals group.

Seven doctors who left the Great Falls Clinic several years ago later sued the clinic, saying their non-compete clause was invalid and they shouldn't have to forfeit shares of accounts worth nearly $1 million.

A state judge last year ruled the noncompete clause invalid, saying state law doesn't allow a contract that prohibits anyone from engaging in a lawful profession. He later awarded the physicians $1.7 million. The case is on appeal to the Montana Supreme Court.

In the Samuels case, her contract said if she worked at any hospital, partnership or the Veterans Administration within 50 miles of Helena within two years of leaving St. Peter's, she had to pay the hospital one-half of her annual income at St. Peter's and money to cover any malpractice claims arising from her work at the hospital.

Samuels argued that the provision is invalid, a restriction on trade, a violation of public policy and a violation of doctor-patient relationships.

Solheim wouldn't comment directly on the case, but said the clause signed by doctors who work for the hospital is "normal for any business."

It applies only if the physician leaves the hospital to work for a large entity that has its own recruiting budget, and not if the doctor wants to join a small practice locally, he said.