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Court affirms hospital arbitrarily denied physician's privileges

Credentialing & Verification Update, September 8, 2008

A California appeals court affirmed a trial court's ruling that a hospital unfairly terminated a physician's privileges in the case of Nasim v. Los Robles Regional Medical Center.

Nasim joined the hospital's medical staff in 2001 with privileges in internal medicine and his subspecialty of nephrology. At the time the hospital granted Nasim privileges, the hospital did not require physicians to be board certified.

During routine peer review of cases at the hospital in 2002, the nephrology department determined Nasim's cases to have been managed appropriately. They also noticed, however, that he was not board certified. The hospital then amended its bylaws to require members of the medical staff to obtain board certification within two years of appointment, and notified Nasim that if he did not obtain board certification prior to his reappointment deadline in December 2003, he would lose his privileges.

Nasim became board certified in internal medicine in August 2003. The next available certification exam in the subspecialty of nephrology, however, was not until November 2004. Upon applying for reappointment, the hospital terminated Nasim's privileges for failing to obtain board certification in nephrology, even though it was impossible for him to do so in the timeframe provided.

The courts ruled that, although it was appropriate for the hospital to amend its medical staff requirements and the hospital gave written notice to Nasim to comply, the hospital did not enforce the requirement unilaterally, as it did not require its hospitalists and many other tenured medical staff members to obtain board certification. Additionally, although the hospital provided Nasim with written notice of the requirement, it did not reasonably give him enough time to comply.

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