Doctors fear precedent in privileges case

The AMA and ISMS join a physician in asking the Illinois Supreme Court to hear his appeal and protect medical staff bylaws.

By Tanya Albert, AMNews staff. Nov. 17, 2003.

A recent Illinois appellate court decision that could clear the way for nonphysician hospital boards to disregard the medical staff's role in deciding who should have privileges has physicians worried that more medical staffs could find themselves usurped if other courts latch onto the ruling.

The court said the hospital board at Provena Covenant Medical Center in Champaign, Ill., had the right to summarily suspend a physician because the hospital's medical staff is "subject to the ultimate authority" of the hospital board.

The judges went on to say that the hospital board has a duty to assess and continuously improve the quality of patient care, and, consequently, that the board had the right to summarily suspend a physician's clinical privileges when "continued practice poses an immediate danger to patients."

That language in the court opinion delivered by the Illinois Court of Appeals, Fourth District, isn't sitting well with doctors. They say allowing a hospital board to make a decision without input from the medical staff violates hospital and medical staff bylaws put in place to ensure that medically trained professionals are reviewing who should be practicing medicine at a hospital.

As a result, the American Medical Association and Illinois State Medical Society are joining Champaign, Ill., cardiovascular surgeon Adolf Lo, MD, in asking the Illinois Supreme Court to hear his case and reverse the lower court decision.

The state's high court takes less than 5% of the cases that are appealed, but the AMA and ISMS say this is an important one. "What the court has done here is to say that if the hospital board feels it has no choice but to act, it has some inherent power to do so," said Saul Morse, ISMS general counsel. "I'm not saying the court realized it was doing that, but because it took so little to get to that conclusion, the opinion says that anytime you need to take action, you can do it."