In the case of Summit Health, Ltd. v. Simon J. Pinhas (1990), ophthalmologist Dr. Simon J. Pinhas claimed that he was forced out of his profession by a group of doctors and hospitals who conspired to monopolize the market for eye surgeries in Los Angeles, violating Section 1 and 2 of the Sherman Act which prohibits anti-competitive practices such as monopolies or conspiracies to create them. Dr. Pinhas sued Summit Health Ltd., Midway Hospital Medical Center, and several individual physicians alleging they had engaged in an unlawful conspiracy to restrain trade by revoking his staff privileges at Midway Hospital because he refused to participate in their scheme involving unnecessary cataract surgeries on Medicare patients. The District Court dismissed his claim stating it did not sufficiently affect interstate commerce - a requirement under antitrust laws - but this decision was reversed by the Ninth Circuit Court of Appeals. On appeal before the Supreme Court, it held that even if an alleged anticompetitive conduct is local in nature (like hospital peer review proceedings), it can still be subject to federal antitrust scrutiny if its effect on competition is substantial enough.

In the dissenting opinion for Summit Health, Ltd. v. Simon J. Pinhas, Justice Scalia argued that the Sherman Act was not applicable in this case as it is intended to prevent economic harm caused by monopolies and anti-competitive practices rather than addressing personal disputes or professional disagreements between doctors and hospitals. He contended that there was no evidence of an adverse effect on competition within a relevant market due to Dr. Pinhas' exclusion from practicing at Midway Hospital in Los Angeles; instead, he saw it as a dispute over medical ethics and hospital privileges which should be resolved through state law or regulatory bodies rather than federal antitrust legislation.