South Dakota hospitals can choose which physicians get privileges, state Supreme Court rules

The state's highest court says hospitals don't have to extend privileges to every qualified physician; organized medicine says limitations ultimately hurt doctors and patients.

By Tanya Albert, AMNews staff. Feb. 5, 2001.

Just because a doctor is medically qualified to practice in a hospital doesn't mean administrators have to open their doors to that physician, the South Dakota Supreme Court said in a January ruling.

Hospitals have the right to limit the number of specialists to whom they'll extend privileges so they can ensure economic survival, the court said. And the medical facility can make the decision without looking at a particular doctor's credentials or abilities.

The American Hospital Assn. says the ruling lets its members make the decisions needed to keep hospitals solvent and provide the best care to the community. But the American Medical Assn. says the ruling makes it difficult for doctors to practice in a given community and limits patients' access to quality medical care.

Both sides filed briefs in the South Dakota case, which they believe will have statewide and nationwide implications. It is one form of a nationwide trend of hospitals' denying privileges based on economic reasons rather than qualifications.

"Hospital boards have a responsibility to meet the needs of their community, and the court said they have the authority to make those decisions," said Maureen Mudron, Washington, D.C., counsel for the American Hospital Assn.

"It's a huge inconvenience for a physician to try to practice in the community and it may put patients at risk," said Randolph D. Smoak Jr., MD, president of the AMA and a South Carolina surgeon.

It is particularly worrisome in rural areas where there is only one hospital serving a large geographic area. If a physician can't practice at the only hospital in the community, doctors may be forced to practice in other communities where they can get hospital privileges, Dr. Smoak said. [...]