Court rules hospital not bound by bylaws

Medical staff bylaws are only a contract with respect to privilege disputes, an Illinois appeals court said.

By Amy Lynn Sorrel, AMNews staff. June 26, 2006.

Illinois physicians say an appellate court ruling will expose them to the whims of hospital boards and ultimately threaten their say in patient care issues if it is allowed to stand.

The Illinois Fourth District Appellate Court, in a 2-1 decision in May, ruled that under Illinois law, medical staff bylaws are only contractually binding when it comes to granting or denying staff privileges. In other circumstances, the judges said, hospital policy takes precedence because courts are "not equipped" to review the nitty-gritty details of hospital and medical staff rules and regulations.

"To delve into the rule-making history of hospital bylaws on an issue such as malpractice insurance requirements is beyond the scope of this court's limited review," Judge Sue Myerscough wrote for the majority.

The ruling comes after Provena United Samaritans Medical Center last year challenged a trial court decision that said the hospital violated the medical staff bylaws when it imposed higher insurance limits on staff doctors without getting proper consent from the medical staff. A group of physicians, some of them struggling to pay the high insurance premiums in Illinois, sued the hospital saying they should be allowed to carry the lower limits of insurance because the medical staff never approved the hospital's decision to raise the limits.

As the first case in Illinois to question the contractual nature of medical staff bylaws beyond privilege disputes, doctors say the ruling could set a dangerous precedent for eviscerating medical staffs' independence.