Dr. Sonny Saggar, the chairman of the emergency department at St. Alexius and owner of Downtown Urgent Care, is being sued by a rival urgent care provider in the St. Louis area — which is accusing Saggar of defaming the company on Facebook.
Saggar acknowledges that he was sharply critical of Total Access Urgent Care on his personal Facebook page. But, he says, he only named the company in his commentary after he received a letter last month from its lawyer, demanding that he take down posts referencing them."At that point, I was basically like, 'OK, you bastards, I will name you,'" Saggar says. "That was the very first time I mentioned Total Access Urgent Care." He's since taken down the posts — but only because the company obtained a temporary restraining order requiring him to do so.
Saggar's attorney, Nick Meador, notes that the restraining order was granted without a hearing. Once they get a chance to make their case, he believes they could be looking at a much different outcome.
"Our investigation is still in the preliminary stages, but I'm highly doubtful his comments have risen to the level of slander or libel," Meador says. "There is a defense of the truth of the matter" — the First Amendment, he notes, provides absolute protection so long as Saggar is telling the truth. Saggar is adamant that he is.
The fight between Total Access and Saggar began innocuously enough. Someone had tagged Saggar on a Facebook post about urgent cares, commenting that they recommended Downtown Urgent Care. In return, Saggar wrote something like, "Thank you. And by the way, we accept Medicaid and we don't CT scan people unnecessarily."
Total Access had also been tagged in the same post, and its founder, Dr. Matthew Bruckel, apparently saw the comment as a dig on his company, which does not accept Medicaid. Saggar says Bruckel called him, angrily accusing him of saying that Total Access was bad. Before excusing himself, Saggar defended himself by saying he didn't name anyone — but Bruckel, he says, was not mollified.
"He called back screaming," Saggar says. At that point, Saggar, who was raised in London, retreated to a Britishcism: "Oh, just piss off, you wanker."
The letter from Bruckel's attorney followed — and, as Saggar continued to post, the situation rapidly escalated. On September 25, Total Access filed suit against Saggar, alleging defamation and tortious interference and seeking an injunction to bar him from further posts. The injunction was granted on a temporary basis on September 27.
Sam Alton, an attorney for Total Access, says the company didn't make the decision to sue lightly. But, he says, Saggar's posts couldn't go unchallenged.
"These posts crossed the line when Dr. Saggar alleges that Total Access engages in some sort of fraud, or scam, or criminal activity," he says. "Believe me, I thought long and hard about this. I knew the First Amendment would be an issue here. But when you have somebody who is a competitor spreading rumors about criminal conduct, and that you turn away the poor and that your doctors don't know what they're doing, that crosses a line."
Alton says he believes Saggar may be motivated to hurt a competitor — and suggests that his slurs on Total Access came after talks about a sale fell through.
But Saggar says his criticism is more simple than that. Yes, he says, he and Bruckel did discuss a sale at one point, but he says he is merely galled that Total Access refuses to take Medicaid, the government program that covers healthcare for low-income people and those with disabilities.
"There is one urgent care provider in town that does not take Medicaid," he says. "Total Access does not. Everyone else does." (Saggar is also concerned that Total Access, which owns its own CT scanner, may be over-prescribing its use. "When you own a hammer, everything looks like a nail," he says.)
In some of his Facebook musings, Saggar has posted that he believes state law should be changed to require urgent care centers to accept Medicaid. In that, he's found support from Pamela Walker, who was the city's health director from 2007 to 2015.
Walker notes that Total Access promises "emergency care without the ER bills."
"If you're going to put yourself out there as an ER, you need to meet the state law standard of not turning anyone away," she says.
The matter of what constitutes "turning away" a patient, however, may end up being the crux of the case against Saggar. Alton, the attorney for Total Access, acknowledges that Saggar was accurate in posting that the company does not accept Medicaid. But, he says, contrary to Saggar's claims, it does not "turn away" the poor.
The company has decided that Medicaid's low reimbursement rates would mean having to see fewer patients — or pass on the costs to others, Alton says. Total Access does serve uninsured patients, he says. "It's one thing to say they don't accept Medicaid," he says. "It's another to say they turn away the poor. It's not the same thing."
Saggar knows he could have made the threat of litigation disappear by shutting his mouth, but he decided he was not willing to do so. When he got the letter demanding he cease and desist, he says, he called his wife.
"I expected her to say, 'Do the defensive thing, do the safe thing,'" he says. "'Sign whatever they want you to sign.' But when I called her, she said, 'Sonny, I know you. You will never be happy if you did that. They're just trying to scare you.'"
He says he's trying to look at his legal predicament with perspective.
"Nobody's trying to kill me, nobody's trying to put me in jail," he says. "I'm impressed by people willing to stand up for what the believe in. I want to be able to hold my head up high."
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