State was concerned that the hiring of physicians and acquisition of physician practices in the Springfield area could reduce competition in some physician specialties. The out-of-court agreement restricted for three years the hiring of physicians in nine specialties who practice in defined service regions of southwest Missouri. The nine specialties covered by the agreement are pediatrics, obstetrics/gynecology, gastroenterology, dermatology, urology, otolarynology, invasive cardiology, oncology/hematology and thoracic surgery. The restrictions weres to apply to each specialty as long as the parent company, Sisters of Mercy Health System – St. Louis, employs 40 percent or more of the physicians who practice in the specialty in the defined service region. The restrictions didl not affect the hiring of physicians from outside southwest Missouri to work in the region. In addition, for three years the parent company agreed under certain circumstances not to enforce contractual limitations on the ability of the physicians it employs in the nine specialties to practice in any location in southwest Missouri after leaving employment with the health system. The agreement also provided that physicians in the nine covered specialties wouldl not have their admitting privileges and access to hospital services at St. John?s restricted because they were not employed by Sisters of Mercy Health System.Sisters of Mercy also paid $30,000 in costs to the Attorney General.