California settlement a big win for medical staff independence

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A July court settlement regarding California’s Tulare Regional Medical Center (TRMC) marks a resounding win for medical staff self-governance. The settlement reinstates—with all of its rights, privileges and status—the organized medical staff that was fired and replaced, and the hospital has agreed to pay $300,000 for the TRMC medical staff’s legal expenses.

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In collaboration with the California Medical Association (CMA), the Litigation Center of the American Medical Association and State Medical Societies has provided significant legal and financial support in the California medical staff’s lawsuit, Tulare Regional Medical Center Medical Staff v. Tulare Local Healthcare District et al. CMA filed pre- and post-trial amicus briefs and organized fundraising for the case.

The suit was filed after the hospital’s board of directors voted Jan. 26, 2016, to terminate the medical staff organization, remove elected medical staff officers, install a slate of appointed officers and approve new medical staff bylaws and rules without staff input.

At the time, CMA legal counsel and litigation director Long Do said the case represented “an existential threat to independent hospital medical staffs.”

The hospital eventually filed for bankruptcy and closed its doors. None of the current members of the hospital’s board of directors were members of its board during the events that were in dispute.

In the settlement, TRMC has agreed to:

  • Not recognize the replacement staff, its leaders or bylaws.
  • Reinstate the original medical staff, its duly-elected officers, with all the privileges, rights and status that existed before the Jan. 26, 2016 termination.
  • Reinstate the pre-existing medical staff bylaws, rules and policies.
  • Pay $300,000 for the TRMC medical staff’s attorneys’ fees and costs .
  • Waive all rights to appeal or challenge the settlement’s validity.

“The settlement is a significant victory in protecting the ability of doctors, individually and through their medical staffs, to care for patients in Tulare County,” CMA President Theodore M. Mazer, MD, said in a statement. “This settlement brings closure to a long legal fight over the improper interference into the physician-patient relationship and the autonomy of a medical staff's responsibility for medical decision making and peer review.

“It sends an important message well beyond Tulare, but most importantly, it allows for the Tulare Regional Medical Center to begin the process of reopening its doors to the patients of Tulare County, who have suffered tremendously from its closure,” Dr. Mazer added.

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