Access: Dr.'s Access 2 Membership
Med Staff in Hosp.
- Org'ed & Self Gov'ing Unincorp'ed Ass'n
- Delegated w/fn. of Q of pat. care
- Members in CA Limited 2
- Dr's of MD / DO's
- Clinical psychologists
- Others can B in Allied Health Prof'l
- Provisional staff
- Proctor supervises proced.
- Proctors has no legal duty 2 intervene &
immune from suit
- Active status: mainstream
- Admit / treat 10-20 pat.'s
- Consulting: not admit pat.'s but consult
- Courtesy: not active & limited 2 5 pat.'s
- To Treat Pat.'s
- Membership +
- Priv.'s Which Def's What Dr.'s Can Do
- Applic. 4 Membership in Med. Staff / Credentialing
- Eval. Member / Applic. 4 Competence
- Query Data Banks
- B & P Code 805 req's hosp's, HMO/ other peer
rev.'s 2 report 2 MBC any X take axn against dr. if restrict priv.'s
/ jgmt settlement more than $30k / face fine of $5k-10k
- So when dr.'s apply, must query MBC & Nat'l
Practitioner Data Bank (fed)
- Failure 2 query in fed. has conseq. of
- Deemed 2 have knowledge
- Malpract. claimant can access data if can prove
hosp. not queried
- Open Staff
- Must admit all qualf'ed
- Denial of Membership: Dr.'s D/P Rts
- Only 4 Med. Discip. Grounds, Not 4 Adm. Grounds
- Subst. D/P Rts
- Must have some rational basis like incompetence
/ disruptive behav.
- Deny b/c of neg. behav. if poses realistic &
specif. threat 2 Q of care
- Proced. D/P Rts
- Notice & opp. 2 B heard
- Dr.'s can exhaust hrgs before denial / restriction
- Summary suspension
- If dr.'s conduct / condition threatens imm. dang.
of harm 2 pat. care
- Imm. denial / restrictions w/o hrg's
- C /L
- Const'al rt. not 2 B deprived b/c fund.'al rt.
2 make living
- CA Busi. Code 809
- Rt. 2 notice of neg. peer rev. / applic.
- Inform hrg rts w/X frame, gen'ly 30 days
- Dr. must req. in writing / waive hrg rts
- Notice of hrg / charges
- Inform of date, X, place of hrg
- X frame 4 hrg
- More specif. than 1st notice
- Issues framed so imp.
- Dr. has rt. 2 receive
- Copies of doc. relev. 2 charges against him
- List of W's
- Hosp. has reciprocal rt. 2 get any relev. doc.
- Arb'or /
- Jud'al rev. committee
- Three / 5 active unbiased med. members w/@ least
1 from same spec. as dr.
- Evid. stand. is prepond. of evid.
- B /p on dr. if denied applic. / on med. staff
if dr. already a member but med. staff always present evid. 1st
- Rules of evid. relaxed so admit any evid. rsbl
person would rely on conduct of serious affairs
- Dr.'s rt. 2 atty
- Det'ed by jud'al rev. committee
- If can't have 1, exec. committee also can't
- Rt. 2 written stmt & written dec. which has
nexus btwn concl. & evid.
- Internal not req'ed: 2 bd. dir'ors of hosp.
- Record rev. 2 see if dec. supported by subst'l
- Dr. has rt. 2 atty & written dec.
- Rt 2 jud.'al rev. after exhausting internal adm.
- Writ of adm. mandamus 2 superior ct: subst'l
- Then 2 appeal & CA Sup Ct.: subst'l evid.
- Rel. Btwn Hosp. & Dr.'s
- Not Ee's B/c Corp. Can't Hire Dr.'s
- Gen'ly Indep. K'or
- Dr.'s member of unincorp'ed ass'n
- Hosp. Based Physicians (HBP) where dr.'s not
have priv. pract.
- ER dr.'s
This material is copyrighted by the author. Use of the material
for profit is strictly prohibited without the written permission
from the author.
May 6, 1997
Ms. Haeji Hong
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