CoMoBUZ Insider Briefing, Aug. 7, 2026

Mike's quick, weekly no-nonsense look at civic affairs in Columbia and Boone County, Missouri. This week, Mike covers the new Boone Health lawsuit against two of its former cardiologists who have opened a clinic in Columbia; reviews the Aug. 4 election results;  and reports on another dustup between MU President Mun Choi and the city council over policing downtown Columbia.

Transcript

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Boone Health's cardiology breakup has moved into a new phase. The hospital is no longer only fighting with the physician group that once ran its heart care operation. It's now asking a Boone County judge to restrict two longtime Columbia cardiologists from practicing at a new local clinic they've opened. The lawsuit reaches beyond a contract dispute. It raises questions about competition, continuity of care, physician independence, and Boone Health's ability to rebuild a major specialty service after the collapse of a deeply integrated relationship. For patients across mid-Missouri, the most important question is still unresolved. Who will be providing that care and under what conditions a year from now? From ComoBuz.com, this is the Como Buzz Insider Briefing, a weekly look at the decisions, documents, and debates shaping Columbia and Boone County. I'm Mike Murphy. This week, Boone Health sues two cardiologists who open the new Pulse Point Clinic and asks the judge to enforce broad non-competition agreements through May of next year. Then on the briefing board, Columbia voters approve Proposition 1 by a razor-thin margin and elect Sharon Jones to the fourth ward city council seat. And University of Missouri President Moon Choi again presses city leaders over downtown safety after a weekend brawl, reopening a dispute over police resources, city policy, and who is responsible for conditions near campus. We begin with Boone Health. Boone Health has sued Dr. James Fairlam, Dr. F. Martin Tabaku, and their new clinic, Pulse Point Clinic. The hospital alleges the two physicians violated individual non-competition agreements by opening and operating a new cardiovascular practice in Columbia after the collapse of Boone Health's longtime relationship with Missouri Heart Center. The case was filed this week in Boone County Circuit Court. Boone Health is asking a judge to prevent Fair Lamb and Tobaku from providing competing cardiovascular services within a large geographic area until after May 6, 2027. At this stage, these are Boone Health's allegations. The court has not ruled on them. The doctors, through their attorneys, have denied that their current work violates the agreements. No hearing date or trial date has been set. Pulse Point remains open. Fairlam and Tobaku remain able to practice unless and until a judge orders otherwise. That is the immediate legal posture. But the lawsuit only makes sense when placed inside the larger cardiology breakup that began publicly last fall. For years, Missouri Heart Center was not simply a group of outside physicians who occasionally treated patients at Boone Hospital. The relationship was much more extensive. Missouri Heart staffed Boone's inpatient and outpatient cardiology services. It also handled major pieces of the service line's management, billing, collection, staffing, budgeting, and daily operations. That arrangement extended beyond Boone Hospital Center in Columbia. It included outpatient operations at clinics in communities across Mid-Missouri, including Boonville, Brookfield, Jefferson City, Macon, Marshall, and Moberly. In practical terms, the hospital and the physicians group had built a cardiology operation that was deeply intertwined. The doctors provided the care, but the relationship also involved employees, leases, equipment, billing systems, patient records, receivables, clinic operations, and physician coverage. That degree of integration is one reason the breakup became so difficult. Missouri Heart notified Boon Health in November of 2025 that it would terminate the professional and management agreements without cause. The termination date was May 6th of this year. Missouri Heart said it wanted to become financially independent while continuing to work with Boon Health under a different contractual structure. Boon Health viewed the proposal very differently. The hospital argued that unwinding the relationship would be complicated, expensive, and disruptive. It also maintained that the physicians and the group would remain bound by non-competition provisions for one year after the contracts expired. The dispute escalated when Missouri Heart explored outside financial backing. The potential investors included Illinois-based heart and vascular partners and New York-based assured healthcare partners. Boone Health alleged that confidential financial and business information was shared during that process without its permission. Missouri Heart rejected Boone's broader portrayal of events. The physician group said it had tried to negotiate a new collaborative agreement and accused Boone Health of responding with legal threats instead of meaningful talks. In March, Boone Health filed its first lawsuit. Boone sought to stop the group from leaving, from using allegedly confidential information and establishing a competing operation with outside financial support. Then came in an emergency dispute over records. In April, Boone Health sought a court order requiring Missouri Heart to restore access to patient and billing information in the company's computer system. Boone later withdrew that request after attorneys began negotiating over access to the information. But by then, the larger relationship was already collapsing. Missouri Heart notified patients that the practice would close May 6th. Boone began hiring former Missouri Heart employees, permanent physicians, and temporary cardiologists to build a replacement service. When Boone opened its new cardiology clinic, three of the 12 former Missouri Heart cardiologists had joined the hospital's new operation. The clinic also opened with four advanced practice nurses and other temporary physicians. Boone Health said it would continue recruiting permanent cardiologists nationally. Fairlam and Tobaku were among the majority of former Missouri Heart physicians who did not join Boone's replacement practice. Instead, Boone alleges that Tobaku organized Pulse Point Missouri MSO on May 6th, the same day the Missouri Heart Agreements ended. Pulse Point launched a website around May 19th. Tobaku then organized Pulse Point Cardiovascular three days later. Boone sent cease and desist letters beginning July 2nd. Attorneys for the doctors and Pulse Point responded several times in July and denied that the clinic violated the agreements. Boone Health has now taken that dispute to court. The non-competition restrictions described in the lawsuit are broad. They cover a 100-mile radius around Boone Hospital Center, except for the Kansas City and St. Louis metropolitan areas. They also cover a 25-mile radius around each of Boone Health's former Missouri Heart Clinics. Boone Health now points out that Pulse Point is operating about six miles from Boone Hospital Center. The hospital says the clinic is marketing, scheduling, and providing cardiovascular care and cardiac diagnostic services covered by the restrictions. The requested injunction would remain in place until after May 6, 2027. That matters because in a medical market like Columbia, a one-year restriction is not simply a question of where a business can open. It can determine whether physicians remain in the community. It can affect where patients continue long-standing relationships, and it can influence whether a new competing practice survives long enough to become established. Boone Health's legal theory is that Fair Lamb and Tobaku accepted compensation under agreements that contained enforceable restrictions. The hospital says the doctors cannot keep the benefits in those arrangements and then immediately compete inside the protected territory. The petition contains three claims. Booth alleges the physicians breached their contracts. It alleges they were unjustly enriched by retaining millions of dollars in Boone paid compensation while engaging in conduct the hospital says undermined the purpose of those payments. And Boone alleges Pulse Point has caused it to lose patience and suffer financial and reputational harm. The hospital is seeking a permanent injunction. It also seeks compensary damages, punitive damages on some claims, court costs, and a jury trial. The doctor's position, as reflected through their attorneys, is that the new practice does not violate the agreements. Their complete legal defense is not yet available in a formal court response. That is important. At this point, we know Boone health's allegations and details. We do not yet fully have an answer filed by Fair Lamb, Tobaccu, or Pulse Point explaining precisely how they interpret the contracts, why they believe the restrictions do not apply, or whether they intend to challenge the agreement as unenforceable. Those issues will matter. Missouri courts do enforce some noncompetition agreements. But enforceability often depends on the specific language, the business interest being protected, the reasonableness of the geographic and time limits, and the facts surrounding the relationship. This case also involves physicians, patients, and access to medical care. That does not automatically invalidate the restrictions, but it gives the dispute consequences that extend beyond ordinary commercial competition. Boone Health has a legitimate institutional interest in protecting a service line, it says it helped finance and build. It also has an interest in preventing former partners from using confidential information or contractual benefits to create an immediate competitor. The doctors have a competing interest in continuing to practice their specialties, serving existing patients and remaining in the community where they built their careers. Patients have an interest in continuity, choice, and clarity. In the broader region has an interest in maintaining enough cardiology capacity. That is why the case cannot be reduced to a simple question of whether Boone Health is right or wrong to sue. The central issue is what the contracts actually require and whether the restrictions Boone seeks are legally enforceable under these circumstances. For now, the most important facts are these. Boone Health has filed a new lawsuit against two former Missouri Heart cardiologists in their new practice. It wants them barred from competing within a broad territory until after May 6, 2027. The doctors deny they are violating their agreements. The court is not ruled, pulse point remains open, and Columbia's cardiology market remains unsettled. This is no longer only a dispute over the end of one contract. It is now a fight over the future structure of heart care in this community. You're listening to the Como Buzz Insider Briefing from ComoBuzz.com. On the briefing board today, Columbia Voters approved a major new public safety tax Tuesday, but only barely. Proposition one passed 15,042 yes voters, 14,957 no votes. That is a margin of 85 votes. The measure adds one cent to Columbia's city sales and use taxes and is expected to produce about $38 million a year for police and fire services. The city's plan calls for 50 additional police officers and 42 firefighters over several years. It also includes police and fire department equipment, vehicles, technology, fire station improvements, two new fire stations, a new police headquarters, and additional support for pension obligations. The result settles the immediate political question. The tax passed, but the narrow margin does not erase the concerns raised during the campaign. Supporters argue that Columbia's population and service demands have grown faster than public safety staffing. Police Chief Jill Schlute said the department has been forced into a reactive model with too few officers for traffic enforcement, downtown assignments, juvenile work, and other specialized functions. Fire Chief Brian Schaefer said Columbia has grown into an urban community without building an urban level of fire protection. Opponents did not necessarily dispute those needs. Their argument focused on city priorities, the burden of a regressive sales tax, and whether Columbia had done enough to control spending before asking voters for another $38 million a year. The closest of the votes suggests those concerns remain politically significant. The practical work now moves to the budget process. City leaders will have to show how the money is collected, separated, allocated, and translated into actual staffing and capital improvements. They will also face scrutiny over whether existing general fund support for police and fire is maintained as the new revenue comes online. In the fourth ward, attorney and lobbyist Sharon Jones won the special city council election. Jones received 3,930 votes. Former City Utilities Director Dave Sorrell received 2,926. Ryan King finished with 812. So now Jones fills the seat vacated by Nick Foster, who resigned after moving to Atlanta with his family. She joins the council as it begins dealing with the next city budget, utility costs, housing policy, and implementation of Proposition 1. And in the Democratic primary for Associate Circuit Judge Bill Ellis defeated Spencer Smith by a wide margin. Ellis received 13,347 votes to Smith's 7,524. He now advances to the general election against Republican James Egan. The second item on the briefing board this week is the renewed confrontation over downtown safety. The immediate trigger was a large brawl near 9th and Walnut Streets early Sunday morning two weeks ago. Seven people were arrested. Videos circulated widely on social media. An officer was struck during the altercation. University of Missouri President Moon Choi responded by sending emails to city leaders expressing what he called grave concern about violent disturbances downtown. He urged the city to reallocate funding toward direct police resources rather than what he described as non-essential investments. Choi called for greater police presence, more technology, stronger support for officers, and effective prosecution. He warned that continued failure to act could lead to a tragic outcome. Mayor Barbara Buffalo pushed back. She said the city has already committed substantial resources to the police department and has used targeted measures along Walnut Street, including parking lot restrictions and adjustment to food truck placement. Buffalo also emphasized that downtown hosted several positive events that weekend and argued that repeated circulation of violent video can overshadow the district's broader activity. First Ward Councilmember Valerie Carroll urged people not to draw conclusions before the police investigation is complete. She also said better staffing would help officers manage weekend crowds. At the same time, Carroll argued for continued support for violence prevention, public health, and programs addressing mental health, domestic violence, and group violence. This is not the first time Choi and city leaders have clashed over downtown. After a fatal shooting last September that killed Stevens College students Ayanna Williams and wounded two other bystanders, Choi declared downtown crime to be at a crisis point. He called for more policing, stricter enforcement, cleanup of homeless encampments, and stronger prosecution. Several council members and homeless advocates accused him of oversimplifying the issue and improperly linking homelessness with crime. The new exchange shows that the underlying dispute remains unresolved, choice these downtown conditions as a direct threat to student safety, the university's reputation, and Columbia's economic health. City leaders say they share the safety concern but reject the idea that enforcement alone is the answer. What happens next is likely to be measured less by another public exchange and more by visible conditions when students return. Police staffing has improved. The city has added resources and technology. The university has its own police force, but weekend crowds, bar closed activity, and recurring violence continues to test the relationship between campus and downtown. The question is whether those institutions can move from public disagreement to a coordinated operating plan. The Boone Health lawsuit and this week's other developments share a common thread. Major institutions are being forced to prove their plans work in practice. Boone Health says it can rebuild cardiology while enforcing the agreements it believes protect that service. City Hall now has voter approval for a major new public safety tax and must show that the money produces the staffing facilities and performance promised during the campaign. And the city and the University of Missouri must show that their overlapping responsibility for downtown can produce something more durable than competing emails after the next violent incident. The legal and political arguments matter, but the public will ultimately judge results. For continuing coverage of the Boone Health Litigation, Proposition 1 implementation, the new Fourth Ward Council member and downtown safety debate, go to Como Buzz.com. We'll be watching for the first formal response from the Pulse Point dependents and any request by Boone Health for an early injunction. We will also follow the city's budget process to see how the new sales tax revenue is incorporated and what commitments are made about existing police and fire funding. And with the students returning soon, downtown conditions will remain a central test for city and university leadership. For Como Buzz.com, I'm Mike Murphy. Thanks for listening. I'll see you next week.