The federal antitrust laws, embodied in the Sherman and Clayton acts, are
intended to protect competition that affects interstate commerce. These laws
apply to all medical practice activities because of the court’s broad definition of
interstate commerce. Antitrust laws have three attractions to physicians
attacking peer review proceedings. As federal laws, they obviate state law
peer review protections. In other business contexts, they are used to attack
exclusionary agreements that have a surface resemblance to medical staff
contracts. Finally, prevailing plaintiffs can recover three times the proved
damages plus their attorney’s fees.
The antitrust laws do not condemn bigness in itself, but they prevent a business
from using its size or control of the market (monopoly power) against its
competitors. The antitrust laws also prevent competitors from reaching
agreements to divide markets (horizontal restraints) or otherwise reduce
competition. The policy of the antitrust laws is to protect competition, not
competitors. There are certain actions, such as price fixing, that are illegal
without reference to their effect on the market. These are called
violations; they are illegal irrespective of the market power of the offenders.
For all other violations, the plaintiff must prove that the business, or
businesses, involved in the alleged violation have a dominant market position.