He led trauma care at one of Idaho’s biggest hospitals. Now, he’s suing
When Dr. Parker Fillmore was dismissed from Saint Alphonsus Regional Medical Center in late 2023, he was barred from getting another job in the Boise area because of a noncompete agreement he’d signed years earlier.
Fillmore, a trauma surgeon, is now suing the hospital, alleging that when Saint Alphonsus terminated his contract, the noncompete interfered with his ability to take a job at West Valley Medical Center in Caldwell. He says the agreement, which he “begrudgingly” signed after hospital administrators assured him the noncompete provision would not be enforced, harms the community, prevents him from earning a living and is unreasonable in length and scope.
The contract stipulates that Fillmore must not provide clinical, administrative or on-call trauma services at any other hospital within 90 miles, including West Valley Medical Center, St. Luke’s Regional Medical Center and Saltzer Health, which closed a year ago, for 18 months after the termination of his contract.
Noncompetes are common in the medical industry. But they’re highly controversial, and efforts in the federal government and in the Idaho Legislature seek to ban most of them.
The American Medical Association, the influential trade association for physicians, advises them not to sign the agreements. But many do anyway: The AMA estimates that noncompetes affect 37% to 45% of physicians in the U.S.
The Federal Trade Commission adopted a comprehensive ban on noncompetes last year, saying the agreements stifle competition, suppress wages and harm workers by limiting their ability to find better opportunities.
The American College of Surgeons said in a letter to FTC Chair Lina Khan in 2023 that noncompete clauses are detrimental to patient care and should be banned in physician contracts. It said the overwhelming majority of its more than 80,000 members have a noncompete clause in their employment contract. But the rule, which was set to take effect in September, was halted after two federal courts issued injunctions. The FTC has appealed those decisions.
State Rep. Todd Achilles, a Democrat from Boise, introduced a bill in the 2025 legislative session that would prohibit noncompete agreements between employers and most workers. Achilles said he intentionally introduced the bill near the end of the session because he wanted to put something on the record that he could have conversations about and revise in the interim before the Legislature convenes again in January.
“You should not be able to restrict somebody’s ability to find a job in their community, particularly after you let them go,” Achilles told the Statesman.
Saint Alphonsus Health System told the Idaho Statesman by email that it won’t comment on active litigation. As of Thursday, it had yet to file a response to Fillmore’s lawsuit in court.
‘Idaho caught my eye’
Fillmore became a doctor in 2012 after graduating from the University of Arizona College of Medicine, where he also obtained a master’s degree in public health.
He completed his residency in general surgery at the University of Nevada School of Medicine. Then he did a fellowship in burn, wound and plastic reconstruction at Johns Hopkins University School of Medicine and a fellowship in surgical critical care at the R. Adams Cowley Shock Trauma Center at the University of Maryland.
In 2016, he moved to Idaho to work at Saint Alphonsus.
He received a copy of his contract after he’d already packed up the U-Haul, he said, and he signed it despite concerns about the noncompete provision. He hoped it was the right decision.
“When I was still in training, Idaho caught my eye, because it was kind of this big black hole for trauma care in the country and had so much potential to make improvements,” Fillmore told the Statesman. “I said, ‘You know what? This is where I want to come to help trauma.’ There’s still so much to do.”
Saint Alphonsus says its Level II trauma center, at its flagship hospital located at 1055 N. Curtis Road, is the most advanced in the state. Idaho has no Level I trauma centers, the highest.
Trauma centers are specially equipped to handle the most traumatic injuries, such as gunshot wounds or severe vehicle accidents that are life- or limb-threatening. Regular emergency rooms typically treat less-life-threatening injuries like broken bones, burns or lacerations requiring stitches. The higher levels, 1 and 2, treat more complex patient traumas. The lower the level, the fewer the resources, and the greater the likelihood that some patients may need to be transferred to a higher-level center after initial treatment.
Lawsuit says understaffing led to burnout
Fillmore said he began noticing problems at the hospital shortly after starting.
“It was typical for Saint Alphonsus to require its trauma surgeons to be physically present in the hospital to work long, unbroken shifts with responsibilities that included covering the emergency room, operating room, intensive care unit and hospital wards simultaneously,” his lawsuit says. “This practice was not advisable for providing safe and effective care … ”
He said it was common for the hospital to require its trauma surgeons to work extra hours without additional compensation because of understaffing, which led to burnout and high turnover. During his first year, he says he was required to work 24-hour shifts and over 300 hours of overtime with no extra pay.
In 2017, he sent a letter to hospital administrators outlining his concerns.
Still, a couple of years later, he renewed his contract, and in mid-2020 was asked to serve as interim trauma medical director after a period of “disarray” in the department. Fillmore said that before he took the position, the hospital had hired and fired three trauma medical directors in a brief time frame. Shortly after, he took on the role permanently. His compensation, however, stayed the same, according to the lawsuit.
Fillmore said that in taking the position he received assurances from administrators that the hospital would shore up its trauma department. He said David McFadyen, who became president of Saint Alphonsus Regional Medical Center around the same time, promised to hire a seventh surgeon on the trauma team, which Fillmore had been pushing for; and to provide the resources to make the hospital a Level I trauma center, which would involve a partnership with a medical school.
McFayden is now CEO of the West Region of Trinity Health. Saint Alphonsus is part of Trinity Health.
But the hospital soon changed its tune, saying it couldn’t afford to hire another surgeon, Fillmore’s lawsuit says. The seventh surgeon was hired only after Fillmore offered to give up a portion of his salary, taking on clinical and administrative duties but for less money, according to the lawsuit.
Hospital loses trauma verification
Meanwhile, Fillmore served in the Idaho Air National Guard. In 2022, he received notice that he could be deployed the following year, and in March 2023 he was sent overseas to Saudi Arabia for three months, returning in late July. He said Saint Alphonsus was aware that he could be obliged to deploy from time to time and he kept the hospital apprised of the notices he received from the military.
Fillmore said he worked with the hospital to appoint an interim trauma medical director in his absence. During his deployment, he made himself available by email and video conference from Saudi Arabia to assist the department.
“I tried my best to set them up for success while I was deployed, but it totally fell apart while I was gone,” Fillmore told the Statesman. “I came back and almost immediately we got reviewed.”
In late November 2023, the results of the review came back: The hospital had lost its trauma verification from the American College of Surgeons.
The nonprofit surgeons college — the same organization that urged the FTC to stop noncompete agreements — certifies trauma centers nationwide and is the largest professional association of surgeons in the world. Its verification process is the “gold standard” for evaluating the quality of trauma care programs and improving patient outcomes, according to the Journal of Trauma and Acute Care Surgery.
After the Statesman inquired about the loss of verification, the health system put out a news release saying that the college’s latest verification review made “four findings that were documentation/administrative in nature” and that it was taking immediate action to resolve the findings and schedule a survey for reverification. Chris Way, then-chairman of the Idaho Time Sensitive Emergency System Council, the state accrediting organization for trauma centers, said Saint Alphonsus has already corrected three of the four problems, with proof.
“I saw the loss of verification as a good thing, because what it does is it creates urgency to correct problems,” Fillmore told the Statesman. “Truth be told, when the reviewer said, ‘It’d probably be helpful to fail you,’ I said: ‘Yeah, I agree with you. I don’t think the hospital is going to be aggressive in correcting these problems unless they fail.’”
Weeks later, the hospital sent him a letter relieving him of his duties as trauma medical director.
Fillmore resigned his hospital privileges immediately and, in response, hospital administrators demanded he fulfill his contractual obligation to work an additional 120 days, or nearly four months. So he did. Then his employment was terminated, according to the lawsuit.
He alleges his contract was wrongfully terminated.
“They needed to have a fall person, and that was me,” Fillmore said. “I just resigned at that point. I thought: ‘It’s time to move on. This is not a good relationship.’”
Saint Al’s sends cease-and-desist letter
In September 2024, despite his agreement not to compete, Fillmore started working at West Valley. He said the Caldwell hospital asked him to help stabilize its trauma program.
He said in the lawsuit that Dr. Mark Nassir, the president of Saint Alphonsus Medical Group, had told him previously that the hospital would not enforce the noncompete provision of his contract.
“I thought, ‘Well, I’m just going to go out into some of the other community hospitals because that’s where the help is needed,’” Fillmore said. “But I knew that they weren’t going to be happy with me working in the region. Once they are done with you, they want you out of the community.”
West Valley is a smaller hospital. It has around 40 patients receiving care at any given time, he said.
Because of its size, he didn’t see the hospital as a threat to Saint Alphonsus, which is the region’s leader in treating the most critically ill and injured adult patients. Pediatric trauma patients, classified as age 14 or younger, are typically handled by St. Luke’s Children’s Hospital in downtown Boise, which is verified by the surgeons college as a Level 2 pediatric trauma center.
“West Valley’s trauma program was struggling, and I see them as a critical component of our trauma system,” Fillmore said. “They don’t see major traumas. But nonetheless, because of the geographic area, people just come to that hospital. They just show up. They’re not brought by EMS, and you need a strong trauma program that can not only stabilize and treat them but also rapidly ship them if they need to go somewhere else.”
But he wasn’t at West Valley for long before he received a letter from Saint Alphonsus’ attorneys seeking to enforce the noncompete clause in his contract.
“Saint Alphonsus is extremely concerned about the risk of you disclosing its confidential and proprietary information,” said the letter dated Nov. 22. “Because your employment at West Valley is in direct violation of the agreement’s noncompete provision, Saint Alphonsus demands that you immediately cease your breach …”
It told him to immediately resign as trauma medical director for West Valley and to stop providing direct or indirect clinical and administrative trauma services to the hospital.
‘Trauma is not a competitive sport’
Fillmore says he didn’t have access to proprietary or confidential information while employed at Saint Alphonsus. He sees the attempt to enforce his noncompete as part of a bigger effort by the health system to ensure that it stays the only provider of Level II trauma care in the Boise area.
His lawsuit accuses the hospital of having a monopoly on Level II trauma care in the Treasure Valley.
“Trauma is not a competitive sport,” Fillmore told the Statesman. “It’s a collaborative sport. You need everyone to participate to get the best results. Saint Alphonsus just doesn’t see it that way.”
In January 2024, West Valley received verification as a Level III trauma center from the Idaho Time Sensitive Emergency System Council, which the Legislature created in 2014 to improve coordination and treatment of care of patients with blunt-trauma injuries, strokes and heart attacks.
The council conducts its own verification reviews to make sure hospitals are meeting its standards, though state law allows it to skip on-site reviews when a hospital has been verified by a nationally recognized accrediting body like the American College of Surgeons. Level III trauma centers typically serve people in more rural areas, allowing patients to be treated for mild to moderate injuries closer to home, according to the American Trauma Society.
Fillmore was reelected in February to the state Time Sensitive Emergency System Council as chair of the southwest region. He also serves as vice chair of the entire council.
Idaho faces physician shortage
St. Luke’s Health System, the largest health system in Idaho and the biggest competitor to Saint Alphonsus, told the Statesman by email that it does not include noncompete provisions in its physician contracts.
While noncompetes started out as a safeguard against intellectual property or confidential information, they’re most often used in health care to protect an employer’s investment in recruiting and training a new physician or setting them up in practice, which can be expensive, according to Dr. David Pate, the former president and CEO of St. Luke’s Health System.
Noncompetes can also safeguard a health system’s customer base. If a doctor leaves a practice for another job in the same area, patients might follow, and the health system could lose money.
“There are situations where it is appropriate,” Pate told the Statesman. “There’s other situations where it’s not so appropriate. For example, if a doctor sets up practice but then wants to leave in 10 years, they shouldn’t have a restriction because it’s not like they just took advantage of the health system until they could get on their feet. They’ve paid their dues, so to speak.”
Pate said that while he was CEO of St. Luke’s, the health system used noncompetes sparingly, and when it did, it applied the shortest time and distance restrictions necessary.
“Our intention was certainly not to make physicians leave areas where we already have physician shortages, if things don’t work out,” he said.
Idaho ranks at the bottom of all 50 states for its supply of doctors per capita. Even in areas of the state with high population density, like the Boise area, patients often face months-long wait times to see primary care physicians, even though most providers are already concentrated there.
The state’s strict abortion ban has further dampened recruitment and retention of physicians. But noncompete agreements, too, are silently driving doctors out of the state or out of work.
“I know at least four trauma surgeons who live in Boise but are not allowed to provide trauma care right now,” Fillmore said.
Noncompetes often require health care workers to abandon established patients, leave the field or uproot their families to relocate. That’s why most professional medical organizations, other than the American Hospital Association, are against them, according to Fillmore.
Other medical workers have noncompetes
Noncompetes aren’t just limited to physicians or health care executives, according to Caitlin O’Brien, a health care and business attorney in Idaho. Midlevel providers, such as physician assistants and nurse practitioners, are also often subject to them.
O’Brien said she’s helped clients on both sides of the issue — writing and enforcing the provisions for hospitals and negotiating them for providers, sometimes even trying to get providers out of them. She said every situation is unique.
“Some employers say, which I think is pretty fair, ‘If we fire you, then you won’t have a noncompete. But if you leave us voluntarily, then you would have a noncompete,’” O’Brien said.
But she acknowledges the other side: “There’s an argument that it doesn’t make sense to restrict people from practicing in the area even once they’ve left a job. At least in the health care arena, where we have a provider shortage across the nation.”
‘It is harmful to the public’
Achilles, the legislator who wants to prohibit most noncompete agreements, said his legislation got some pushback from the Idaho Hospital Association.
Toni Lawson, the association’s vice president, told the Statesman that the association is mostly concerned about how the legislation would affect physician groups and the potential impact on hospitals’ ability to recruit and retain specialists.
“We always have concerns when government wants to insert itself into private contracting issues,” she said.
Achilles said his legislation was born from what he sees as noncompetes expanding from their original use among executive-level positions down to entry-level jobs. He said they have a dampening effect on wages and undermine free markets.
“You shouldn’t be able to fire somebody or force somebody out and then continue to hold them to a noncompete,” Achilles said. “What’s that person going to do? It’s an abusive use of noncompete agreements. That sort of practice needs to stop.”
His proposed bill includes exceptions for a sale or dissolution of a business, and for executive employees earning more than $250,000 per year.
Fillmore, who owns a home in Eagle, said he doesn’t want to pull his children out of school so that he can work somewhere else. He said he wants to provide for his family, give them stability and contribute to the community he already lives in.
“In this case, it is harmful to the public, and our laws should not support something that intentionally hurts the public,” he said.
This story was originally published May 2, 2025 at 4:00 AM.
