You Can’t Revoke a Doctor’s Hospital Privileges Without Due Process

This ain’t your grandfather’s medical practice anymore, is it?

The modern doctor must deal with a dizzying array of rules and regulations like the one we covered last week.

At the same time, California law affords you certain protections that can’t be bargained around or contracted away, as a hospital found out when it tried to revoke a doctor’s staff privileges.

The doctor was an anesthesiologist who’d practiced at the hospital for twenty years until a state audit called him out for some stuff, and he was put on probation.

Then an internal audit noted some additional problems, and the hospital leaned on his medical group to fire him. According to their contract, the hospital could force the medical group to remove any doctor from the roster that was assigned to it. When the hospital enforced that provision, the medical group got rid of him.

So the hospital technically didn’t revoke the doctor’s privileges, but it effectively did something similar.

And that turned out to be a mistake.

The law says a doctor is entitled to a legal process before a hospital can revoke her privileges, membership, or employment. Among other things, you’re entitled to know what you’re accused of doing or not doing, and you’re entitled to a hearing before neutral arbiters where you can scrutinize the evidence and cross-examine witnesses. The hospital bears the burden of proof. And the law says you can’t waive these rights by contract.

Had the hospital followed this administrative peer-review process to revoke the doctor’s privileges, it might’ve been immune from liability.

As it happened, the doctor sued and won a $4 million judgment that was affirmed on appeal.