California deal reaffirms medical staff autonomy

CMA says this case underscores the need for medical staffs to retain their own lawyers.

By Tanya Albert, AMNews staff. Sept. 6, 2004.

One of the more public fights between a hospital's medical staff and its administration and board has been resolved in a way that physicians say maintains the independence they need, while also fostering better cooperation between the two sides.

"Things are definitely looking up," said orthopedic surgeon John Hill, MD, medical staff president at Community Memorial Hospital in California. "The most important thing is that we accomplished the things we set out to do."

What the medical staff set out to do more than a year ago was to re-establish a balance between the hospital and medical staff that allows physicians to protect patients' safety and lets administrators ensure the hospital is financially sound.

The California physicians hope their agreement will serve as a model for other physicians embroiled in conflicts with hospitals nationwide.

Relationships between the two entities have traditionally experienced some strain, but the tension has mounted as financial pressures on both have increased.

Things became so strained for doctors on the medical staff at Community Memorial Hospital of San Buenaventura in Ventura, Calif., that they sued the hospital in 2003 after the board adopted policies recommended by the administration that took away the medical staff's right to self-govern.

For example, the hospital adopted a 20-page "Medical Staff Code of Conduct" under which the hospital gave itself the authority to investigate and discipline physicians not meeting the conduct standards. The hospital also decided that physicians with a financial stake in an entity competing with the hospital couldn't hold a medical staff leadership position or vote as a staff member.