Judith Nelson and Darci Anne Bowman, Cross-Appellees v. Monroe Regional Medical Center, Formerly Known as the Monroe Clinic, Cross-Appellant

CUDAHY, Circuit Judge,

concurring:

I am completely in accord with the analysis and conclusions of the majority opinion. Whatever deficiencies the plaintiff's antitrust claims may eventually evince, they are certainly not lacking as allegations of antitrust injury. In fact, the plaintiff has suffered what is the very essence of antitrust injury. The merger of the Monroe Clinic and the Monroe Medical Center has ostensibly eliminated all competition in the provision of medical services in the Green County market. It was this elimination of competition and the resulting effective monopoly position of the Monroe Clinic that made the Clinic’s refusal to deal with Darci Bowman injurious to her. Because she had no other supplier with which to deal, Bowman was forced to seek service in another market allegedly to her detriment. The injury to her was thus the direct result of the injury to competition. Although perhaps not a matter of major moment in dollars and cents, the merger and the related refusal to deal lie at the heart of the evils addressed by the antitrust laws. Further development of the facts underlying market definition and other matters may very well exculpate the Monroe Clinic, but a finding of antitrust injury certainly requires no extension of well-accepted antitrust principles and concepts.

With respect to the interstate commerce nexus, we must observe caution when importing principles derived from cases involving denial of staff privileges to the different context of the provision of medical service. We are concerned here with the issue of delivery of the Clinic’s principal product — a matter at the very core of its economic activity. In these circumstances, we should not give the jurisdictional requirements of the Sherman Act an inappropriately narrow reading.