The War Is On: Why Your Medical Staff Needs to Incorporate and Obtain Its Own Independent Counsel

Charles Bond, Esq.


Medscape General Medicine. 2004;6(1):e36 

In This Article

The National Campaign Against Medical Staff Independence

The hospital lawyers, of course, are quite adept at packaging their proposals in smooth language to make them sound fair and reasonable. They are teaching these strategies at seminars at posh resorts and at medical staff meetings across the country (Footnote 6). A recent weekend seminar in Santa Fe, New Mexico entitled "Governance Problems & Solutions" included topics such as, "What is a medical staff and why doesn't it work?," "'Delegating' to the medical staff without abdicating," and "How does the board deal with 'medical staff' issues -- disruptive physicians, quality of care?" all on the first day's agenda. According to Horty Springer's Web site, Partner Dan Mulholland was one of the workshop's faculty.

Mulholland taught at Horty Springer's "Physician Contracts, Competition & Joint Ventures" seminar at the Ritz-Carlton in San Francisco in October 2003. The seminar promised to "help you evaluate your options and respond appropriately -- without breaking the law!" Seminar participants received "model agreements and practical tips to use when you get home," including "Board Policy on Competing Financial Interests" and "Medical Staff Financial Disclosure Form." Sound familiar? It may soon.

Hospital attorneys are also attacking medical staffs in the courts across the country to establish their agenda. In New Hampshire, the Horty Springer firm convinced the State Supreme Court to rule that the medical staff is not a separate entity from the hospital.[2] In South Dakota, attorneys got the state Supreme Court to hold that a hospital can deny privileges to qualified doctors based on the hospital's own economic agenda.[3]

Now, Horty Springer is on the attack in California. BondCurtis LLP represents the Medical Staff of Community Memorial Hospital in Ventura California, where the hospital administration and Board of Directors has:

  • Taken the Medical Staff's bank account;

  • Tried to oust duly elected medical staff officers and replace them with administration appointees;

  • Unilaterally imposed an 18-page "Code of Conduct";

  • Adopted a Conflict of Interest Policy without medical staff consent or input;

  • Unilaterally amended medical staff bylaws;

  • Bypassed the medical staff credentialing process;

  • Refused to turn over charts for regular departmental peer review; and

  • A host of other violations of medical staff prerogatives.

In other parts of the country, hospitals have introduced these concepts gradually, but in Ventura, the administration has pulled out all the stops and is giving the medical staff "The Full Monty," -- an undiluted full dose of all the repugnant policies at once.

Courageously, the medical staff filed a lawsuit to challenge the hospital's unilateral power grab. The doctors seek to preserve a functioning, self-governing medical staff while the hospital wants to place outright control of "access to the hospital premises" in the hands of the administrator and ultimately require doctors to adhere to the administrator's economic agenda. The battle lines are drawn: the American Medical Association (AMA) and California Medical Association (CMA) are on the side of the Medical Staff, and -- just so there is no ambiguity as to where the hospital industry stands -- the California Hospital Association has entered the lawsuit backing the administration. Significantly, the court ruled that the medical staff was a separate, independent entity with standing to bring such a suit. The hospital administrator resigned, and the case now appears to be settling.

Medical staffs are under attack in other states, including Ohio and Florida. Horty Springer lawyers are in the thick of it.