Med staff-hospital fights turn nasty and more litigious

Lawsuits are expected to keep coming as the economics of medicine evolves.

By Tanya Albert, amednews staff. April 19, 2004.

Judges this year will decide how much authority hospital boards have over medical staffs as the two square off in courtrooms nationwide.

For years, tension has been commonplace in physician-hospital relationships, and the two sides are no strangers to the legal system. But mounting economic pressures as well as heightened focus on quality of care are pushing more and more hospital boards and medical staffs to ask the courts to resolve disputes.

New lawsuits in Florida, Arkansas and Idaho join suits filed last year in California, New York and Ohio giving courts a key role in solving what has become an ongoing struggle for power.

"The court is usually a last-ditch resort," said John D. Blum, a law professor at Loyola University in Chicago who focuses on medical quality assurance. "When the parties go to court, there is open hostility, and they are not on the same page."

Indeed, that is the case in the three latest lawsuits.

Generally speaking, hospital medical staffs say they need autonomy to make decisions about who is granted privileges, and they say they should determine when peer review is done.

Medical staff members argue that they are best able to make decisions that most serve the interest of patients. And they say they have the skill and training necessary to initiate and conduct peer review.

Hospital boards counter that they have the ultimate responsibility to ensure that hospitals meet their communities' needs and to ensure that their institutions are financially strong.

[...]

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