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Privileging disputes: Follow your policies

Medical Staff Leader Connection, December 23, 2004

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Dear Medical Staff Leader:

When a physician is not granted requested privileges, he or she will often threaten to sue the hospital and its medical staff leaders for restraint of trade or violation of antitrust statues. This is especially true if the reason for not granting privileges is a privileging dispute with another specialty. All too often, such threats strike fear in medical staff leaders and lead to paralysis of action, which is precisely the intent of the person making the threat. Instead, medical staff leaders should feel confident that their process will stand up to legal scrutiny-and it will, if you have the correct processes for managing privileging disputes.

Today, anyone can sue for any reason. However, there is not a court in the country that will substitute its judgment for the judgment of a medical staff and governing board, provided that they, acting in good faith, follow a fair and thoughtful process and document it well. This process should clearly identify and address conflicts of interest. It should avoid any votes by those who do or could compete with the physician requesting privileges. It should provide clear, rational justifications for any final decisions. And these justifications should be based on quality of care and the institution's legitimate need to carry out its mission. If these are all in place, then you have nothing to fear from a legal suit.

You can't stop someone from suing. But if you have clear policies that you consistently follow, and document your processes well, you should have nothing to fear. In fact, the physician threatening to sue will probably have a difficult time finding an attorney who will take the case on a contingency bases, and that is a good thing for you and your institution.

All the best,

Rick Sheff, MD
http://www.greeley.com/seminars/

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