Logan Health Didn't Renew the Physician Who Led Its Providers' Union Bargaining. A Week Later He Started at a DPC Clinic in Kalispell.

At Logan Health in Kalispell, Mont., Dr. Ruben Hipolito had a panel of close to 2,000 patients and often saw 20 to 26 of them a day. In the first week and a half at his new clinic, about 50 joined his panel.

The new job is at True North MT, a direct primary care clinic off Three Mile Drive that opened Oct. 5, according to the Flathead Beacon. How he got there runs through a union drive, a contract that wasn’t renewed and a retaliation complaint filed with the National Labor Relations Board.

A contract, a union and a complaint

Hipolito joined Logan Health as a family physician in 2019. In January, primary care providers across the system’s clinics voted 49 to 28 to be represented by the Union of American Physicians and Dentists. They cited inadequate staffing and growing patient panels, with some physicians seeing at least five new patients a day and some panels near 1,800.

Hipolito helped lead the organizing effort. When contract talks began in April, he became head of the providers’ bargaining committee, the Beacon reported in July.

At the end of June, physician leaders told him his contract would not be renewed when it expired at the end of September. Union representatives who sat in on that meeting said the hospital pointed to patient satisfaction scores. His profile on Logan Health’s own website showed 4.6 out of 5 stars across 370 reviews at the time.

Logan Health tells it differently. In a statement to KPAX, the system said the matter “predates the provider union activity at Logan Health” and “concerns the decision not to issue a new employment contract to a physician, not the termination of an existing contract.”

One detail in the record cuts toward that timeline. In a May email quoted by the Beacon, Hipolito wrote that at his contract renewal “in September, I was initially offered a 2 yr contract which was rescinded in place of a 1 yr contract.” The Beacon, writing in July, dated that renewal to “last September,” which would put it before the January union vote. The Beacon also reports he had been organizing “behind the scenes,” without saying since when.

Hipolito and the union filed a retaliation complaint with the NLRB. The Beacon reports the case is waiting to be heard, and that a win would likely bring back pay for what he would have earned at Logan Health, minus what he earns at his new job.

In July, he was still hoping to stay. “Ultimately I want to work with Logan Health because I know Logan Health can be a great organization,” he told the Beacon. “That’s why I’m fighting for change.”

Fourteen patients on a busy day

The week after his contract lapsed, Hipolito helped cut the ribbon in Kalispell. True North first opened in Hamilton in 2022 with a doctor and a nurse. In Kalispell, Hipolito works with a medical assistant and an RN.

In the DPC model, the Beacon explained, patients pay a monthly fee for round-the-clock access to an RN or doctor. Where he often saw 20 to 26 patients a day at Logan, he expects 14 on True North’s busiest days.

“Work-life balance is much better in this model,” Hipolito told the Beacon. “It’s better for patients, and it’s better for me.”

Many of his first 50 patients are new. A good number followed him from Logan Health. The clinic’s Kalispell page lists chronic disease management, pediatrics, minor procedures and sports medicine, along with IV nutrition and hormone replacement.

Where the other patients go

In July, Hipolito spoke about the people he would leave behind. “My patients are going to be the ones who are displaced,” he said. “That’s not fair.”

In its statement to KPAX, Logan Health said “claims that thousands of patients will be left without access to a physician are inaccurate.” It said it had added 21 primary care providers over the past year, five of whom are scheduled to join this fall.

The arithmetic of his new panel doesn’t settle that argument either way. The Beacon’s own 2025 look at DPC in the Flathead Valley reported that DPC rosters often run 300 to 700 patients. By that measure, a full DPC panel would hold a fraction of the list Hipolito carried at Logan. The same article noted that small panels mean DPC can “add to the problem, at least in the short-term” for a thin primary care workforce.

He also isn’t the first Logan physician to make this move. Dr. Kelly Berkram spent 16 years in family medicine at Kalispell Regional Healthcare, now Logan Health, before opening Apex DPC in August 2024, kitty-corner from the medical center. Montana had eight DPC clinics in 2021. By mid-2025 at least 32 providers in the state were working under the model, the Beacon reported, citing Frontier Institute data.

For an employed physician, the two paths Hipolito tried this year pull in different directions. When the providers voted, the Beacon reported that their first contract talks with Logan would prioritize staffing and patient panels. A DPC practice sets one physician’s panel and leaves the rest of the list with the hospital.

True North’s Kalispell clinic is accepting patients now. “We’re open, we’re happy to take people, and happy to do health care,” Hipolito said.