Judicial Advocacy

Medical staff autonomy at stake in state supreme court case

| 2 Min Read

Physicians are standing their ground Tuesday in oral arguments before the Minnesota Supreme Court for a case that holds in the balance the ability of the state’s hospital medical staffs to self-govern and stand up for patient safety.

In this case, the medical staff of Avera Marshall Regional Medical Center is seeking to re-establish its autonomy after the hospital’s governing board unilaterally amended the medical staff’s bylaws. The move effectively stripped physicians of “nearly all rights and responsibilities” as the experts in medical direction. 

“[I]f the hospital is allowed to erode the medical staff bylaws,” a friend-of-the-court brief states, “then that is the first step toward erosion of the rights that the medical staff bylaws are designed to safeguard, including the right (and obligation) of a member of the medical staff to exercise her best clinical judgment in caring for her patients.” 

The brief was filed by the Litigation Center of the AMA and State Medical Societies and four other medical associations.

The case has come before the state supreme court following lower court decisions that upset the unique balance that must be struck between medical staff autonomy and hospital governance.

“The medical staff bylaws serve an important function in protecting patient care, which represents a balance between the needs of individual patients and the imperatives of the institution,” the brief argues. “This balance was struck by hospitals and physicians generally within the industry, long before this dispute arose, and it was reflected in the medical staff bylaws in this case. By its ruling, the trial court upset this balance.”

Federal and state laws require hospitals to maintain medical staff bylaws to limit hospital power in areas of medical staff governance.

The physicians are urging the court to restore the medical staff's autonomy to ensure an accountable balance between patient care and corporate interests at the hospital.

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