Health Law

Cal. Appeals Court Holds Medical Staff Retroactive Board Certification Rule Unfair

By Greg Piche'

Dr. Sohail Nassim held provisional medical staff privileges in internal medicine and nephrology at Los Robles Regional Medical Center near Los Angles, California. He joined the medical staff of Los Robles in 2001. After he arrived, the hospital's internal medicine department changed the qualification rules to limit membership to those subspecialists who were board certified within 2 test dates following completion of speciality training. In order for Dr. Nassim to take the nephrology test he was required to first pass his internal medicine boards. These requirements made it virtually impossible for him to comply with the timing requirements.

These requirements were allegedly applied only to new physicians who were not yet subject to monitoring and peer review. Dr. Nassim had provisional privileges and was subject to monitoring and his quality of care was determined to be appropriate.

After obtaining his board certification in internal medicine, the hospital granted him active privileges in internal medicine for two months while the hospital reviewed more of his cases and then the hospital sought to remove his privileges in their entirety because of alleged quality of care issues. Dr. Nassim requested a hearing and it was determined that there was no basis to remove his staff privileges, but that he had lost his nephrology privilges for failure to comply with the hospital's retroactive rule on the timing of board certification. Interestingly, the hospital's staff doctors were exempt from the rule and there was evidence that this was a "designer rule" adopted largely for its application to Dr. Nassim.

Dr. Nassim brought an application for a writ of mandate requesting the reinstatement of his privilges in nephrology on the basis that it impermissibly divested him of a vested property right without due process of law. The trial court granted the writ and the HCA hospital appealed. The appellate court affirmed the the grant of the writ finding that the retroactive application of the rule really designed to apply only to one doctor without a reasonable opportunity to comply was fundamentally unfair. See Nassim v. Los Robles Medical Center, B202144 (August 19, 2008).
http://www.morelaw.com/verdicts/case.asp?n=B202144%26s=CA%26d=36935.

There is entirely too much of this bad behavior going on in medical staff decisions, where doctors eat their young for reasons of economics, politics and/or bias. The cost of this litigation to Dr. Nassim, which is far from over, in terms of a personal and financial drain is likely to be extraordinary. He ought to be at least able to recover his attorneys fees for responding to this type of purile medical staff behavior.

Full post as published by Healthcare Law Blog on September 23, 2008 (boomark / email).