An ongoing legal battle between a Bay Area neurologist and her former employer is shedding light on financial pressures in medicine that experts say could intensify as more doctors’ practices get absorbed by large health systems.

Dr. Diana Blum, who now runs a private neurology practice in Menlo Park, worked for Palo Alto Foundation Medical Group from 2009 until she resigned in 2013. Two years later, she sued the group and its affiliates, Palo Alto Medical Foundation and Sutter Health, alleging administrators retaliated against her and pushed her out for complaining about policies she felt harmed patients.

According to Blum’s lawsuit, doctors at the practice were:

•Encouraged to characterize ailments as more complex, so the group could bill insurers at higher rates.

•Discouraged from referring patients to specialists outside the Sutter network so as to not lose the business.

•Encouraged to prescribe generic instead of brand-name drugs to cut costs.

•Not given enough time and resources to treat their patients because they had to meet productivity standards.

“There was this constant push to see patients more quickly, see patients in shorter interval times, see more patients in an hour,” Blum said during the trial, which concluded in February. “And so patients that should have been given 60 minutes were constantly being put in 30-minute slots, and I couldn’t do my job. ... It impaired my ability to take care of them.”

Palo Alto Foundation Medical Group denies the allegations, saying Blum did not raise concerns about patient care until after she left the practice and sued the group — an account that Blum disputes. Marcie Isom Fitzsimmons, an attorney representing the medical group, said Blum’s complaints during her employment were about the pay system and scheduling — “normal workplace gripes that have nothing to do with patient care,” Fitzsimmons argued at trial.

The trial in Santa Clara County Superior Court ended with Blum being awarded $28,415 for a breach of contract claim. Blum’s other claims, including wrongful termination and retaliation, were dismissed or withdrawn after the judge deemed there was not enough evidence for the jury to hear some of them.

Now, Blum must pay nearly $1.3 million in legal fees incurred by the medical group. That might sound strange, but under California law, because Blum won less at trial than the $201,000 the medical group had offered her earlier to settle the case, Blum must cover the cost of the medical group’s legal fees, the judge ruled in July. Blum plans to appeal.

Blum’s case against Palo Alto Medical Foundation and Sutter has been dismissed. The remaining conflict over legal fees is between Blum and Palo Alto Foundation Medical Group.

Three former doctors at Palo Alto Medical Foundation say they too felt forced to rush through appointments to see as many patients as possible. Doctors were evaluated in part by how quickly they could open and close cases and other metrics they felt were aimed at maximizing profits, according to the other doctors, who declined to be named because some still work in the medical profession and treat patients who seek care at Palo Alto Medical Foundation.

Palo Alto Foundation Medical Group CEO Rob Nordgren said in an email that “while the group, like most medical groups, is conscientious of its economics, patient care always comes first and our doctors have full autonomy to make the best medical practices for their patients. Dr. Blum had her opportunity to try her claims in front of a judge and jury, and the judge’s and jury’s rulings speak for themselves.”

A PowerPoint presentation that was among the pretrial documents and obtained by Blum’s attorney suggests the medical group emphasized the importance of increasing productivity to hit targets for 2013 involving “relative value units” — one measure of physician productivity. “It’s all about throughput ... more patients per hour ... more patients per exam room,” according to the presentation, which Blum’s lawyer said she saw at a shareholder meeting during her time at the medical group. An expert witness for the medical group, Dr. Bryan Bohman, said at trial that it is common for large health care organizations to be concerned about throughput, and that measuring productivity this way helps patients get access to care.

Experts say such concerns among doctors are not specific to any single health system like Sutter, but rather are becoming more frequent across the medical industry. Hospitals and health systems are acquiring doctors’ practices at a much faster rate than in previous decades, and it’s making some doctors feel they have less independence to make medical decisions. From 2012 to 2016, the proportion of U.S. doctors employed by hospitals increased from 26 percent to 42 percent, according to an analysis by the consulting firm Avalere Health.

Similarly, in California, the percentage of doctors in medical practices owned by hospitals grew from 25 to 40 percent between 2010 and 2016, according to a study released last week by UC Berkeley health economists.

“A health care system looks at cost and productivity, not just the care of the patient,” said Richard Scheffler, a professor of health economics at UC Berkeley and the lead author of the study. “It changes everything because the system has to deal with costs, improve productivity, it’s owned by the hospital and they want to tell (doctors) to do more so they can bill more. There’s nothing ethically wrong with that, but it does conflict with the autonomy of doctors, who are used to calling their own shots.”

Catherine Ho is a San Francisco Chronicle staff writer. Email: cho@sfchronicle.com Twitter: @Cat_Ho