Chapter 10.C.1 (or 4.C.1.) -- Medical Staff Structure

In California, a heated dispute over conflicts credentialing at one hospital (Community Memorial Hospital of San Buenaventura) led to the state medical association sponsoring a bill, that was enacted in 2004, affirming the self-governing status of the hospital medical staff and its right to be legally represented as a distinct entity, separate from the hospital.  See Am. Med. News, July 21, 2003; 13 BNA Health L. Rev. 1397 (2004).  For an entertaining video providing the medical association's point of view, see  http://www.calphys.org/html/bb465.asp

Discussing hospital-physician relations generally, see Robert Berenson, et al., Hospital-Physician Relations:  Cooperation, Competition, or Separation?, 26(1) Health Aff. w31 (Jan. 2006); James F. Blumstein, Of Doctors and Hospitals: Setting the Analytical Framework for Managing and Regulating the Relationship, 4 Ind. Health L. Rev. 209 (2007); Lawrence Casalino et al, Hospital-Physician Relations: Two Tracks and the Decline of the Voluntary Medical Staff Model, 27(5) Health Aff. 1305 (Oct. 2008).

Also upholding hospitals' business decisions to use exclusive contracting or close the medical staff for particular departments, see Radiation Therapy Oncology, P.C. v. Providence Hosp., 906 So. 2d 904 (Ala. 2005); Baptist Health v. Murphy, 2006 Ark. LEXIS 58 (Ark. 2006); City of Cookeville v. Humphrey, 126 S.W.3d 897 (Tenn. 2004). In an unusual case, a Florida hospital went to the state legislature to settle a power struggle with its medical staff, obtaining legislation that gave the hospital unilateral power to veto actions of the medical staff. However, the Fla. Sup. Ct. struck this down as an unconstitutional “special law,” after extensive discussion of the “privileges” it conferred to the private hospital. Lawnwood Medical Center v. Seeger, (Fla. 2008). See http://www.law.uh.edu/Healthlaw/perspectives/2008/(AK)%20lawnwood.pdf

For more on hospitalists, see Hoangmai Pham, Hospitals and Care Transitions, 27(5) Health Aff. 1315 (Oct. 2008).

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