Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-09T06:08:24.408Z Has data issue: false hasContentIssue false

The Physician's Right to Due Process in Public and Private Hospitals: Is There a Difference?

Published online by Cambridge University Press:  01 January 2021

Extract

This article will discuss the rights of a licensed physician to acquire and retain a hospital medical staff appointment. The focus of the discussion will be the relationship between the independent fee-for-service private practitioner and the community general hospital. The relationship of the organized medical staff to both the hospital and the individual doctor will also be clarified. The hospital involved this discussion may be owned by a governmental unit and hence identified as a “public hospital,” but more likely it will be aprivate, non-profit charitable corporation and will be referred to as a “private” hospital. Specifically, this article will explore the differences, if any, between a physician's rights vis-a-vis the public hospital and his or her rights when a private hospital is involved.

Excluded from this analysis are situations where the doctor is an employee of a hospital or health care institution. Also excluded are cases involving hospitals which limit their service to particular patients (e.g., the mentally ill or children), and university-owned teaching hospitals that impose a faculty appointment in the medical school as a pre-requisite to staff privileges.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1981

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Joiner v. Mitchell County Hosp. Auth., 125 Ga. App. 1, 2, 186 S.E.2d 307, 308 (1971), aff' d 229 Ga. 140, 189 S.E.2d 412 (1972); Purcell v. Zimbelman, 18 Ariz. App. 75, 500 P.2d 335, 341 (1972); Gonzales v. Nork, No. 228566 (Sacramento Co. Super. Ct., Cal. 1973), rev'd on other grounds, 131 Cal. Rptr. 717 (1976); Corleto v. Shore Mem. Hosp., 138 N.J. Super. 302, 309, 350 A.2d 534, 537 (1975); compare Schenck v. Gov't. of Guam, 609 F.2d 387 (9th Cir. 1979) (District Court did not err in declining to apply emerging theory of independent or corporate hospital liability).Google Scholar
E.g., Gilstrap v. Osteopathic Sanitorium, 224 Mo. App. 798, 810–12, 24 S.W.2d 249, 256 (1929) (implied agency found as basis for employment of physician by sanitorium); c.f., Mulligan v. Wetchier, 39 App. Div.2d 102, 105, 332 N. Y. S.2d 68, 72 (1972) (hospital staff not bound to intervene in treatment of physician's private patient); Hoover v. Univ. of Chicago Hosp., 51 Ill. App.2d 263, 366 N.E.2d 925 (1977) (hospital not liable for assault by physician employee where tort was outside scope of employment).Google Scholar
When there is no employment relationship, there is no vicarious liability; a hospital is not liable for the negligence of an independent contractor physician. Cooper v. Curry, 92 N.M. 417, 589 P.2d 201 (1979).Google Scholar
See supra note 1. See also Mich. Comp. Laws Ann.§331.422 (1970); Mich. Stat. Ann.§14.1179 (12) (1969); Ind. Code Ann.§16–10–1–6.5 (Burns) (1973); Ariz. Rev. Stat. Ann.§36–445 (1972).Google Scholar
Shields, J.C., Guidelines for Reviewing Applications for Privileges, The Hospital Medical Staff 9(9): 1117 (Sept. 1980).Google ScholarPubMed
For a concise statement of a public hospital's duty, See Moore v. Bd. of Trustees of Carson-Tahoe Hosp., 88 Nev. 207, 211–12, 495 P.2d 605, 608 (1972).Google Scholar
Hayman v. Galveston, 273 U.S. 414, 416–17 (1927); Sosa v. Bd. of Managers of Val Verde Hosp., 437 F.2d 173, 176–77 (5th Cir. 1971).Google Scholar
See Kraemer, Shelley v., 334 U.S. 1 (1948); Burton v. Wilmington Parking Auth., 365 U.S. 715 (1961).Google Scholar
E.g., Sosa v. Bd. of Managers of Val Verde Hosp., supra note 7 (notice of charges “reasonably related to operation of hospital” required for denial of admission to medical staff); Moore v. Bd. of Trustees of Carson-Tahoe Hosp., supra note 6 (hospital board may not act unreasonably or arbitrarily in denying restoration of medical staff privileges, even though conduct charged was not specifically prohibited by hospital by-laws).Google Scholar
Sams v. Ohio Valley Gen. Hosp. Ass'n, 413 F.2d 826 (4th Cir. 1969) (rule that staff physicians must locate their offices in the same county as hospital found unreasonable); Simkins v. Moses H. Cone Mem. Hosp., 323 F.2d 959 (4th Cir. 1963), cert. denied, 376 U.S. 938 (1964) (allegations of racial discrimination in staff appointments); Silver v. Castle Mem. Hosp., 53 Haw. 475, 497 P.2d 564, cert. denied 409 U.S. 1048 (1972) (procedural due process found lacking where hospital failed to provide specific written charges prior to hearing for revocation of staff privileges).Google Scholar
Barrett v. United Hospitals, 376 F. Supp. 791 (S.D.N.Y. 1974), aff'd. mem., 506 F.2d 1395 (2d Cir. 1974). See also, Waters v. St. Francis Hosp., 618 F.2d 1106, 1107 (5th Cir. 1980) (codification of common law right authorizing revocation of staff privileges does not convert revocation to state action); Hodge v. Paoli Mem. Hosp., 576 F.2d 563, 564 (3rd Cir. 1978) (mere receipt of Hill-Burton funds insufficient basis to support state action claim).Google Scholar
Barrett v. United Hospitals, supra note 11, at 797.Google Scholar
Id. at 800–05.Google Scholar
Id. at 799.Google Scholar
42 C.F.R.§405.1021 et seq. (1979).Google Scholar
Joint Commission on Accreditation of Hospitals, Accreditation Manual for Hospitals (Chicago, 1980) at 93–94; See generally, Darling v. Charleston Community Hosp., 33 Ill.2d 326, 211 N.E.2d 253 (1965), cert. denied, 383 U.S. 946 (1966) (JCAH standards are admissible in court and failure to adhere to them can constitute evidence of negligence).Google Scholar
See infra notes 20 and 21 and accompanying text.Google Scholar
See supra note 15.Google Scholar
See supra note 16.Google Scholar
Griesman v. Newcomb Hosp., 40 N.J. 389; 192 A.2d 817 (1963).Google Scholar
Woodard v. Porter Hosp., 125 Vt. 419, 217 A.2d 37 (1966); Hagan v. Osteopathic Gen. Hosp., 102 R.I. 717, 232 A.2d 596 (1967); Khan v. Suburban Hosp., 45 Ohio St.2d. 39, 340 N.E.2d 398 (1976); Bricker v. Sceva Speare Mem. Hosp., 111 N.H. 276, 281 A.2d 589 (1971); Kinsie, Hawkins v., 540 P.2d 345 (Colo. App. 1975); McElhinney v. William Booth Mem. Hosp., 544 S.W. 2d 216 (Ky. 1977); Ascherman v. St. Francis Mem. Hosp., 45 Cal. App.3d 507, 119 Cal. Rptr. 507 (1975); Storrs v. Lutheran Hospitals of America, 609 P.2d 24 (Alaska 1980).Google Scholar
Guerrero v. Copper Queen Hosp., 22 Ariz. App. 611, 529 P.2d 1205 (1974), aff' d mem. 537 P.2d 1329 (1975) (private hospital); Williams v. Hosp. Auth. of Hall County, 119 Ga. App. 626, 168 S.E.2d 336 (1969) (public hospital).Google Scholar
42 U.S.C.§291 et seq. and §300 et seq., 44 Fed. Reg. 29372 (1979).Google Scholar
Civil Rights Act of 1964, 42 U.S.C. A. §2000(c) (1966); 42 U.S.C.A. §1395 et seq. (1973); see also e.g., Simkins v. Moses H. Cone Mem. Hosp., supra note 10 (participation in Hill-Burton program by private hospital sufficient basis for “state action” in denial of medical staff appointments and patient admissions on the basis of race); Foster v. Mobile County Hosp. Bd., 398 F.2d 227 (5th Cir. 1968) (state legislative creation and receipt of state and federal funds sufficient basis for finding “state action” in case involving alleged denial of staff privileges on basis of race).Google Scholar
Parker v. Port Huron Hosp., 361 Mich. 1, 11–25, 105 N.W.2d 1, 6–13 (1960) (charitable immunity exception to general rule of tort liability, the bases for which are no longer compelling).Google Scholar
Parker v. Highland Park Hosp., 404 Mich. 183, 273 N.W.2d 413 (1978) (operation of hospital is not “state action;” fact that public hospital operates for the “common good of all” does not distinguish it from private hospital since modern hospital, public or private, operated essentially as a business).Google Scholar
Khan v. Suburban Hosp., supra note 21 (required applicants for appointment to document their training, experience, and specialty board certification or eligibility as a prerequisite for the granting of major surgical privileges); Rao v. Bd. of County Commissioners, 80 Wash.2d 695, 497 P.2d 591 (1972) (required references).Google Scholar
Green v. City of St. Petersburg, 154 Fla. 3, 17 So.2d 517 (1944); Khan v. Suburban Hosp., supra note 21; Selden v. City of Sterling, 316 Ill. App. 455, 45 N.E.2d 329 (1942) (mandated supervision for surgical privileges where surgeon's competence needed documentation or where a limited practitioner was granted privileges).Google Scholar
Fahey v. Holy Family Hosp., 32 Ill. App.3d 537, 336 N.E.2d 309 (1975) (required non-departmental physician to consult with qualified department member before performing any major surgery); Mem. Hosp. v. Pratt, 72 Wyo. 120, 262 P.2d 682 (1953) and Peterson v. Tucson Mem. Hosp., 559 P.2d 186 (Ariz. App. 1976) (required timely completion of medical records); Yeargin v. Hamilton Mem. Hosp., 229 Cal. 870, 195 S.E.2d 8 (1972) (required service in hospital's emergency room).Google Scholar
Yeargin v. Hamilton Mem. Hosp., supra note 29, Klinge v. Lutheran Hosp., 383 F.Supp. 287 (D.Mo. 1974), modified 523 F.2d 56 (8th Cir. 1975) (required adherence to reasonable medical staff by-laws, rules and regulations); Citta v. Delaware Valley Hosp., 313 F.Supp. 301 (E.D. Pa. 1970); Baron, Duby v., 369 Mass. 614, 314 N.E.2d 870 (1976) (sustained rule providing for summary suspension of staff member in circumstances indicating an immediate threat to safety of patients); Koelling v. Skiff Mem. Hosp., 259 Iowa 1185, 146 N.W. 2d 284 (1966); Laje v. Thomason Gen. Hosp., 564 F.2d 1159 (5th Cir. 1977) (documented clinical incompetence considered grounds for suspension or discipline).Google Scholar
Pollack v. Methodist Hosp., 392 F.Supp. 393 (E.D. La. 1975); Holmes v. Hoemaka Hosp., 573 P.2d 477 (Ariz. 1977); Renforth v. Fayette Mem. Hosp., 383 N.E.2d 368 (Ind. App. 1978).Google Scholar
Davis v. Morristown Mem. Hosp., 106 N.J. Super. 33, 254 A.2d 125 (1969) (periodic re-evaluation required).Google Scholar
Guerrero v. Burlington County Mem. Hosp., 70 N.J. 344, 360 A.2d 334 (1976).Google Scholar
Walsky v. Pascack Valley Hosp., 145 N.J. Super. 393, 367 A.2d 1204 (1976).Google Scholar
E.g., Blank v. Palo Alto-Stanford Hosp. Ctr., 234 Cal. App.2d 377, 44 Cal. Rptr. 572 (1965); Rush v. City of St. Petersburg, 205 So.2d 11 (Fla. App. 1968).Google Scholar
Adler v. Montefiore Hosp., 452 Pa. 60, 311 A.2d 634 (1973) (cardiac catheterization); Dattilo v. Tucson Gen. Hosp., 533 P.2d 700, 23 Ariz. App. 396 (1975) (nuclear medicine); Lewin v. St. Joseph Hosp., 82 Cal. App. 3d 368, 146 Cal. Rptr. 892 (1978) (renal hemodialysis).Google Scholar
Griesman v. Newcomb Hosp., supra note 20; Foster v. Mobile County Hosp. Bd., 398 F.2d 227 (5th Cir. 1968); Ware v. Benedikt, 225 Ark. 185, 280 S.W.2d 234 (1955); Hamilton County Hosp. v. Andrews, 227 Ind. 217, 84 N.E.2d 469 (1949).Google Scholar
Milford v. People's Community Hosp. Auth., 380 Mich. 49, 155 N.W.2d 835 (1968).Google Scholar
Sams v. Ohio Valley Gen. Hosp. Ass'n, supra note 10 (county lines per se do not relate to hospital's service area or to doctor's availability and ability to serve hospitalized patients adequately).Google Scholar
Ascherman v. St. Francis Mem. Hosp., 45 Cal. App.3d 507, 119 Cal. Rptr. 507 (1975); Foster v. Mobile County Hosp. Bd., supra note 37.Google Scholar
Armstrong v. Fayette County Gen. Hosp., 553 S.W.2d 77 (Tenn. App. 1977).Google Scholar
Shaw v. Hosp. Auth. of Cobb County, 507 F.2d 625 (5th Cir. 1975) (podiatrist entitled to hearing); Davidson v. Youngstown Hosp. Ass'n, 19 Ohio App.2d 246, 250 N.E.2d 892 (1969) (private hospital must act reasonably in passing on applications for staff membership); Touchton v. River Dist. Community Hosp., 76 Mich. App. 251, 256 N.W.2d 455 (1977) (cannot summarily dismiss application of podiatrist). Compare Aasum v. Good Samaritan Hosp., 395 F.Supp. 363 (D. Ore. 1975). But see Boos v. Donnell, 421 P.2d 644 (Okla. 1966) (chiropractors can be excluded from hospital staffs). Some state statutes prohibit hospitals from arbitrarily discriminating against persons practicing in certain allied health profession. E.g., Cal. Health & Safety Code §1316 (1974) and §1316.5 (1978); Nev. Rev. Stat. §450.430 and §450.005 (1975).Google Scholar
Of course, requiring a due process hearing does not require the hospital to grant the podiatrist privileges. Shaw v. Hosp. Auth. of Cobb County, supra.Google Scholar
N. Y. Pub. Health Law §2801-b (McKinney) (1973) (podiatrists and others may not be denied staff privileges without stating reasons). In this connection See Fritz v. Huntington Hosp., 39 N.Y.2d 339, 348 N.E.2d 547 (1976); Fried v. Straussman, 393 N.Y.S. 2d 334, 361 N.E.2d 984 (1977).Google Scholar
See Reynolds v. St. John's Riverside Hosp., 382 N.Y.S.2d 618 (Sup. Ct. 1976) (physician's assistants must be considered by a hospital for privileges).Google Scholar
Theissen v. Watonga Mun. Hosp. Bd., 550 P.2d 938 (Okla. 1976); Peterson v. Tucson Gen. Hosp., 114 Ariz. 66, 559 P.2d 186 (Ariz. App. 1976); contra, Wyatt v. Tahoe Forest Hosp. Dist., 345 P.2d 93 (Cal. App. 1959).Google Scholar
Sosa v. Bd. of Man. of Val Verde Hosp., supra note 7 (physician abandoned obstetrical patients in active labor when they could not pay his fee; possessed an unstable physical demeanor and visible nervousness likely to jeopardize surgical patients; subject to fits of anger and rage; frequently moved the locus of his practice; had pled guilty to two felony charges in the past; had suffered suspension of medical license in Michigan and Texas (since restored in Texas); and failed to supply satisfactory current references).Google Scholar
Anderson v. Caro Community Hosp., 10 Mich. App. 348, 159 N.W.2d 347 (1968).Google Scholar
Bailey, Huffaker v., 540 P.2d 1398 (Ore. 1975) (by-law provision not unduly vague and reasonably related to quality of patient care); quoted in Ladenheim v. Union County Hosp., 76 Ill. App.3d 90, 394 N.E.2d 770 (1979).Google Scholar
See, e.g., Miller v. Eisenhower Med. Center, 166 Cal. Rptr. 826, 614 P.2d 258 (1980); see also Staube v. Emanuel Lutheran Charity Bd., 287 Ore. 375, 600 P.2d 381 (1979); Ong, Robbins v., 452 F.Supp. 116 (S.D. Ga. 1978).Google Scholar
Rosner v. Eden Township Hosp. Dist., 58 Cal.2d 592, 375 P.2d 431, 25 Cal. Rptr. 551 (1962).Google Scholar
Joint Commission on Accreditation, Accreditation Manual for Hospitals, supra note 16, at 95, 103–05.Google Scholar
Silver v. Castle Mem. Hosp., supra note 10, 53 Haw. at 484–85; 497 P.2d at 571–72.Google Scholar
Garrow v. Elizabeth Gen. Hosp., 155 N.J. Super. 78, 92, 382 A.2d 393, 400 (1977).Google Scholar
Klinge v. Lutheran Charities of St. Louis, 523 F.2d, 56, 63 (8th Cir. 1975); Hortonville Joint Sch. Dist. No. 1 v. Hortonville Educ. Ass'n, 426 U.S. 482, 493 (1976).Google Scholar
Woodbury v. McKinnon, 447 F.2d 839, 844 (5th Cir. 1979); Ascherman v. San Francisco Med. Soc., 39 Cal. App.3d 623, 648, 114 Cal. Rptr. 681, 697 (1974).Google Scholar
Silver v. Castle Mem. Hosp., supra note 10, 497 P.2d at 571; Ascherman v. San Francisco Med. Soc., supra note 55, 114 Cal. Rptr. at 697.Google Scholar
Anton v. San Antonio Community Hosp., 140 Cal. Rptr. 442, 458, 567 P.2d 1162, 1178 (1977).Google Scholar
Garrow v. Elizabeth Gen. Hosp. & Disp., 79 N.J. 549, 566–67, 401 A.2d 533, 541–42 (1979).Google Scholar
Brickman v. Bd. of Dir. of W. Jefferson Gen. Hosp., 372 So.2d 701, 705 (La. App. 1979).Google Scholar
Joint Commission on Accreditation, Accreditation Manual for Hospitals, supra note 16, at 104.Google Scholar
Johnson, R.L., How Much Process Is Due? Trustee 32(10): 32 (October 1979).Google ScholarPubMed
E.g., Garrow v. Elizabeth Gen. Hosp., & Disp., supra note 58, 401 A.2d at 538; Brickman v. Bd. of Dir. of W. Jefferson Gen. Hosp., supra note 59; Shulman v. Wash. Hosp. Center, 348 F.2d 70 (D.C. Cir. 1965).Google Scholar
Margolin v. Morton F. Plant Hosp. Ass'n, 348 So.2d 57 (Fla. App. 1977).Google Scholar
Burkette v. Lutheran Gen. Hosp., 595 F.2d 255 (5th Cir. 1979).Google Scholar
Kushner v. Southern Adventist Health and Hosp. Syst., 260 S.E.2d 381 (Ga. App. 1979).Google Scholar
Sosa v. Bd. of Man. of Val Verde Hosp., supra note 7, quoted in Laje v. Thomason Gen. Hosp., supra note 30, at 1163.Google Scholar