Suing for Her Freedom: How Dr. Nyasha Spears Won Her Non-Compete Battle and Built Amity Creek Direct Primary Care in Duluth, Minnesota

Dr. Nyasha Spears

When Dr. Nyasha Spears walked into a mandatory 4 PM meeting that had been called with less than four hours notice, she already knew something was wrong. Her century-old community clinic in downtown Duluth, the legacy practice founded by Dr. Rudy nearly a hundred years earlier, was being closed by the corporate hospital system that had absorbed it. She had 36 days to figure out the rest of her career.

What happened next is one of the most important DPC origin stories you will ever hear. Dr. Spears, family physician and co-founder of Amity Creek Direct Primary Care, sued the hospital system for her freedom and won. A Minnesota judge issued a temporary injunction ruling that physician non-competes are against the public interest. In April, she opened the doors of Amity Creek alongside her partner, Dr. Kristen Lusian.

In her recent conversation with Dr. Maryal Concepcion on the My DPC Story podcast, Dr. Spears shares the full arc of her journey. Here is what every DPC-curious physician trapped in a non-compete or watching their community clinic disappear into a corporate system needs to take away from her story.

A Place That Lives in Your Soul

Dr. Spears did not grow up in Duluth, but she calls her connection to the city almost a religious experience. As a third-year medical student attending a rural healthcare conference, she watched a February sunrise over Lake Superior from a revolving restaurant and knew this was where she was supposed to be. She did her residency in Duluth, met her husband there, practiced 70 miles south in Ashland, Wisconsin for ten years, and eventually returned to Duluth to raise her family.

When she decided to open a DPC practice, leaving Duluth was not an option. She wanted her kids to come back and feel that this was home. Every community needs physicians, and Dr. Spears was determined to be one of the physicians her community needed.

The takeaway: If you love your community, you do not have to leave it to practice the kind of medicine you believe in. You may have to fight for it, but you can stay.

When a Community Hospital Becomes a Corporation

Dr. Spears practiced at PS Rudy Clinic, a downtown Duluth practice with deep roots and an extraordinary patient population. The clinic served corporate executives from Maurice's headquarters, low-income seniors in nearby single-occupancy housing, homeless residents from the shelter a block away, and multi-generational families who had been coming to PS Rudy since Dr. Rudy himself was practicing.

Then the community hospital was absorbed into a corporate system. Everything changed. Lab and X-ray services disappeared from the clinic. Front desk staff went home at 4 PM regardless of patient need. Messages were routed to a different city to people who did not know the physicians or patients. Patients could not get annual exams scheduled less than 18 months out.

Dr. Spears describes the experience as making her angry all the time, which is not who she is. The corporate model, she says, makes physicians into widgets and patients into transactions.

The takeaway: If your practice has been absorbed by a corporate system and you no longer recognize the medicine you are practicing, you are not imagining it. The grief is real, and it is shared.

When Patients Notice the Loss Too

Dr. Spears emphasizes that her patients felt the changes as keenly as she did. People who chose the community hospital specifically because it was a community hospital began to grieve. They knew when their messages were not getting through. They knew when scheduling became impossible. They knew their physician no longer had the support to take care of them the way she once had.

The takeaway: Patients are not fooled by corporate transitions. They feel the loss. And many of them are looking for somewhere new to land.

How Direct Primary Care Found Her

Dr. Kristen Lusian, a colleague and friend from Dr. Spears' Ashland days, called her one day with an idea. She wanted to leave her hospital system and open a direct primary care practice. She seemed almost to be asking Dr. Spears for permission. Dr. Spears told her to run.

At the time, Dr. Spears had barely heard of DPC. But over the following months, as her own corporate dissatisfaction grew and her clinic was eventually closed, the DPC model became the answer she had been looking for. When PS Rudy Clinic was shuttered, she knew exactly what she wanted to do next.

The takeaway: The DPC physician who calls you for advice may be the one who introduces you to the model that changes your life. Take the call.

Why "Don't Lawyer Up" Did Not Work

At a DPC summit, an attorney advised Dr. Spears to avoid getting lawyers involved and simply have a reasonable conversation with her employer. She tried. She approached her hospital system as a reasonable professional offering a win-win arrangement. She would leave, they would no longer pay her salary, overhead, staff, or malpractice, and she would refer her patients back to them for hospital care, surgery, oncology, and cardiology.

They were having none of it.

Dr. Spears acknowledges that the "don't lawyer up" advice is still worth trying because if it works, it is the cleanest path. But she warns that the corporatization of healthcare has eliminated the professional respect that makes these conversations possible. Be prepared for the conversation to fail.

The takeaway: Try the reasonable approach first. Do not be surprised when it fails. Have your legal team ready.

Exploring Every Option Before Litigation

Before suing, Dr. Spears explored every workaround imaginable. She considered buying a mobile home and parking it just outside her non-compete catchment area. She drove the rural roads of northern Minnesota looking for sheds she could convert into clinical space. She looked at an orthopedic office an hour and a half away in Virginia, Minnesota, and a shabby Airbnb 45 miles out.

None of it felt right. The catchment was designed to make these workarounds impractical, and Dr. Spears did not want to use a small community as a stepping stone back to Duluth. Eventually, she realized litigation was the only path forward that aligned with her values.

The takeaway: Explore every option, but trust your gut when none of them feel right. Sometimes the only way out is through.

Suing for Her Freedom

Dr. Spears worked with Jeff Oberman, an attorney she has never met in person but describes as a teammate and a believer in DPC. He filed a complaint that focused on two strong arguments: the hospital had violated her contract by closing the clinic with only 36 days notice instead of the contractually required 180 days, and the non-compete was against the public interest because it restricted patient access to a critical resource.

The judge wrote a remarkable response and granted a temporary injunction in Dr. Spears' favor. He used clear, strong language affirming that physician non-competes are against the public interest. This was the first time her attorney had successfully made this argument in court, as previous similar cases had settled before reaching a ruling.

The takeaway: A great attorney who understands DPC can be the difference between staying stuck and opening your doors. The right legal argument can set precedent that benefits every physician who comes after you.

How Partnership Made the Pre-Opening Phase Possible

Because Dr. Spears was legally barred from being financially involved in the practice while her non-compete was being litigated, Dr. Lusian opened the LLC alone. Dr. Spears served as her unpaid advisor, helping with location decisions, interior design, name selection, and the endless minutiae of opening a practice. They kept the partnership scrupulously clean so no one could later claim she had financial involvement.

Dr. Spears notes that DPC partnership reduces decision fatigue. The volume of choices required to open a practice, from used autoclaves to door swings to budget priorities, is enormous. Having a partner means you do not carry every decision alone.

The takeaway: If you are considering DPC, consider whether a partner could help carry the cognitive load of starting up. Partnership done well is a gift.

What Her Husband's Story Reveals About Corporate Medicine

Dr. Spears' husband, Dr. Brian Capps, planned to stay in their corporate practice to provide income and health insurance during the DPC startup phase. When a residency faculty position opened up at the local program, it seemed like the perfect transition. Both institutions involved appeared to support the move.

Then everything fell apart. Days after Dr. Capps gave his 180-day notice, Essentia posted a job description with a 0.2 direct patient care component that triggered his St. Luke's non-compete. Neither system would budge to rewrite the job. Dr. Capps was left without a parachute. He eventually returned to Ashland, 70 miles away, where he now practices outside the non-compete zone.

The takeaway: Even a clean transition with two cooperating employers can fall apart. Plan for the worst case. Document everything.

Serving the Patients She Was Meant to Serve

In her first week at Amity Creek, Dr. Spears saw a 62-year-old woman with catastrophic insurance who had not seen a doctor in years. The woman had family history of colon and breast cancer, had been mugged at gunpoint 18 months earlier, and was experiencing crippling anxiety for the first time in her life. She had been avoiding care because every visit cost too much. In one DPC appointment, Dr. Spears sat with her, listened, and scheduled a follow-up the next week to continue the conversation.

She also saw a Black woman she had known from her previous practice who had felt shuffled around and dismissed in the corporate system. In DPC, that patient could finally feel known.

The takeaway: The patients you are meant to serve will find you. DPC restores the kind of medicine you went into this profession to practice.

The Takeaway for Aspiring DPC Physicians

If you are stuck inside a non-compete, watching your community clinic disappear into a corporate system, or wondering whether the system you are in still values you, Dr. Spears' story makes several things clear:

The corporate model is not your only option. Patients are grieving the loss of community medicine. Physicians are no longer treated as professionals in many corporate settings. The DPC community is full of partners, mentors, and attorneys who can help you find your path out.

Try the reasonable approach first. Hire a great attorney when reasonable fails. Explore every workaround, but do not waste years on solutions that do not align with your values. Find a partner if you can. Document everything. And when the door opens, walk through it.

Your community needs you. Your patients are looking for you. The freedom to practice medicine the way you were trained to practice it is worth fighting for.

🎧 Listen to the full conversation with Dr. Nyasha Spears on the My DPC Story podcast wherever you listen.

📲 Visit mydpcstory.com for the Start Here page, free resources, and the DPC Toolkit Magazine.

If you are DPC-curious or fighting your way out of corporate medicine, mydpcstory.com is here to meet you wherever you are. Find your starting point today.

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