CMA recently told a California appeals court that it must prevent hospital governing boards from unlawfully usurping medical staffs’ peer review authority. In this case, El-Attar, M.D. v. Hollywood Presbyterian Medical Center, the medical staff executive committee (MEC) found no basis to deny a physician’s reappointment to the medical staff. Despite this decision, the hospital’s lay governing board bypassed the MEC and picked its own biased peer review panel, which included physicians with economic ties to the hospital. The hospital-appointed panel then refused to renew the physician’s medical staff privileges.

Despite medical staff bylaws that clearly require peer review hearing officers and judicial review committees be appointed by the medical staff, a lower court ruled that this “delegation” of peer review activity was permissible. On appeal, the hospital does not appear to deny that it violated the bylaws, but rather, argues that the purported delegation of authority was permissible under California law. CMA believes that neither the medical staff’s bylaws nor California law supports such an interpretation. CMA submitted an amicus brief explaining that medical staffs cannot, except in rare circumstances, delegate this critical responsibility. Medical staffs are required to abide by their bylaws, and those bylaws must be consistent with the fair hearing provisions as defined in California’s Business & Professions Code (§§809 et seq).

Also at issue in this case is the proper standard for determining the impartiality of hearing panel members. The lower court ruled that the standard is whether there is a “direct financial benefit.” CMA also explained it its brief that the proper test is not whether someone is “actually biased,” but whether “a person aware of the facts might reasonably entertain a doubt that the judge would be able to act with integrity, impartiality, and competence.”

CMA has urged the court to carefully scrutinize the facts in this case to ensure that the peer review process was conducted fairly.

Click here to read CMA's brief.

Contact: Astrid Meghrigian, 916/444-5532 or ameghrigian@cmanet.org.