Peer Review and “Disruptive Physician” Cases Physicians Should Know

Although Meyers v. Columbia/HCA Healthcare Corp.is one of the major cases concerning  termination of clinical privileges and peer review hearings, there have been other recent clinical privileges cases that are important for physicians to know when confronted with a peer review action. This is especially true if the physician is being accused of disruptive behavior.

One such case is Isaiah v. WHMS Braddock Hospital Corp., decided in 2008. In this case, Dr. Isaiah’s medical staff privileges were revoked after hospital staff members reportedly expressed concerns about the surgeon’s surgical skills and allegedly compulsive behavior. Dr. Isaiah argued that his behavior did not impact his skills. The court concluded that the hospital’s revocation of Dr. Isaiah’s medical staff privileges was immune from liability under the federal Health Care Quality Improvement Act (HCQIA) because the hospital acted in an attempt to protect quality health care, which relates not only to a physician’s abilities, but also to the doctor’s behavior.

In 2009, Abu-Hatab v. Blount Memorial Hospital was decided, again in favor of the hospital. In this case, Dr. Abu-Hatab sued Blount Memorial Hospital after his medical staff membership and clinical privileges had been terminated due to his allegedly disruptive behavior. Dr. Abu-Hatab argued that allegations of his poor conduct were not true. However, the court decided that it didn’t matter whether the complaints were undisputedly true. Under the Health Care Quality Improvement Act, as long as a hospital and its medical staff act “reasonably” in considering complaints, the professional review actions are protected. According to the court, the hospital’s many meetings concerning Dr. Abu-Hatab’s behavior were enough to show that it acted reasonably.

Another case reported originally in 2009, Leal v. Secretary, U.S. Department of Health and Human Services, involved a urologist, Dr. Leal, who held clinical privileges at Cape Canaveral Hospital in Florida. According to the reported court decison, after being told he would have to wait to use an operating room, Dr. Leal exhibited behavior that led the hospital to suspend his clinical privileges for sixty (60) days. The reported decisions state that Dr. Leal broke a telephone receiver and copy machine, threw jellybeans into a trash can in a medical suite, shoved a metal cart and spoke sternly to a nurse. The hospital filed a report of its action taken against Dr. Leal with the National Practitioner Data Bank (NPDB), which was established under the Health Care Quality Improvement Act (HCQIA) to collect information on the professional conduct and competence of health care practitioners. Dr. Leal felt that he should not have been reported to the NPDB and challenged the action. However, the trial court found that the decision to report Dr. Leal to the NPDB was supported by the HCQIA, which requires a report to the NPDB for a professional review action that adversely affects the clinical privileges of a physician for a period longer than thirty (30) days. This decision was also upheld by the appellate court (the Eleventh Circuit Court of Appeals) in 2010.

One of the more recent clinical privileges cases is Badri v. Huron Hospital, decided in 2010. According to case reports, in this case Dr. Badri was involved in a car accident. Allegedly, the other driver involved choked Dr. Badri. Dr. Badri then began experiencing neck pain for which he self-medicated with steroids. He was then accused of disruptive behavior after several alleged incidents of poor conduct towards hospital employees and patients. When deciding Dr. Badri’s case, the court relied on Meyers, which provides authority for immunity for hospitals and medical staffs in professional review actions that cite a physician’s disruptive behavior as undermining quality health care.

These are just a few of many cases concerning clinical privileges and peer review actions where the hospital involved is found to be acting in accordance with the Health Care Quality Improvement Act and therefore not liable.

If you are a physician or any hospital staff member accused of disruptive behavior, misconduct, “rudeness,” disrespectful conduct or language, abusive acts, anger, hostility, profanity or other similar acts. beware. This is a serious matter. It could result in adverse peer review action that could be career-ending.

If you are concerned that your medical staff privileges may be suspended or revoked, or if you are currently facing a peer review action, make sure you consult an experienced health care attorney who is familiar with matters regarding clinical privileges.

For more information about clinical privileges, peer review, or fair hearings, please visit our website at wwww.TheHealthLawFirm.com.