Mounting tension over autonomy: Courts referee doctor-hospital battles

Physicians are worried about the impact on patient safety.

By Tanya Albert, AMNews staff. July 21, 2003.

Relationships between hospital boards and medical staffs are showing signs of strain nationwide as more physicians open facilities that compete with hospitals and as hospital budgets tighten.

But physicians at a California hospital say their situation has reached the breaking point and that the hospital has stripped the medical staff of its right to self-governance.

Medical staff members in Ventura, Calif., are speaking out -- and going to court -- because they say they don't want this to happen elsewhere.

Under new policies at Community Memorial Hospital of San Buenaventura, any physician who has a financial stake in an entity that competes with the hospital can't hold a medical staff leadership position. Nor can he or she vote as a staff member.

The hospital also adopted a 20-page "Medical Staff Code of Conduct," and gave itself authority to investigate and discipline physicians who don't meet the standards. Physicians say the hospital also unilaterally amended medical staff bylaws so they wouldn't conflict with new corporate bylaws and took control of the staff dues account.

"While we've seen attempts of erosion of bits and pieces, this is a full-blown assault," said Charles Bond, a Berkeley, Calif., attorney representing the medical staff.

The medical staff's lawsuit, filed in state court, claims that the hospital is "putting financial gain above the interests of patients" and claims the hospital has "embarked upon a dangerous and unlawful effort to destroy the legally recognized role of the medical staff in protecting patients in the hospital," according to court filings.