Access: Dr.'s Access 2 Membership

Med Staff in Hosp.

  1. Charact.'s
    1. Org'ed & Self Gov'ing Unincorp'ed Ass'n w/Bylaws
      1. Delegated w/fn. of Q of pat. care
    2. Members in CA Limited 2
      1. Dr's of MD / DO's
      2. Dentists
      3. Podiatrist
      4. Clinical psychologists
      5. Others can B in Allied Health Prof'l
    3. Categ.'s
      1. Provisional staff
        1. Proctor supervises proced.
        2. Proctors has no legal duty 2 intervene & immune from suit
      2. Active status: mainstream
        1. Admit / treat 10-20 pat.'s
      3. Others
        1. Consulting: not admit pat.'s but consult
        2. Courtesy: not active & limited 2 5 pat.'s / yr.
  2. To Treat Pat.'s
    1. Membership +
    2. Priv.'s Which Def's What Dr.'s Can Do
  3. Applic. 4 Membership in Med. Staff / Credentialing Process
    1. Eval. Member / Applic. 4 Competence
    2. Query Data Banks
      1. 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
      2. So when dr.'s apply, must query MBC & Nat'l Practitioner Data Bank (fed)
      3. Failure 2 query in fed. has conseq. of
        1. Deemed 2 have knowledge
        2. Malpract. claimant can access data if can prove hosp. not queried
    3. Open Staff
      1. Must admit all qualf'ed
  4. Denial of Membership: Dr.'s D/P Rts
    1. Only 4 Med. Discip. Grounds, Not 4 Adm. Grounds
    2. Subst. D/P Rts
      1. Must have some rational basis like incompetence / disruptive behav.
      2. Deny b/c of neg. behav. if poses realistic & specif. threat 2 Q of care
    3. Proced. D/P Rts
      1. Notice & opp. 2 B heard
      2. Dr.'s can exhaust hrgs before denial / restriction of membership
      3. Summary suspension
        1. If dr.'s conduct / condition threatens imm. dang. of harm 2 pat. care
        2. Imm. denial / restrictions w/o hrg's
      4. C /L
        1. Const'al rt. not 2 B deprived b/c fund.'al rt. 2 make living
      5. CA Busi. Code 809
        1. Rt. 2 notice of neg. peer rev. / applic.
          1. Rsns
          2. Inform hrg rts w/X frame, gen'ly 30 days
        2. Dr. must req. in writing / waive hrg rts
        3. Notice of hrg / charges
          1. Inform of date, X, place of hrg
          2. X frame 4 hrg
          3. More specif. than 1st notice
          4. Issues framed so imp.
        4. Discov.
          1. Dr. has rt. 2 receive
            1. Copies of doc. relev. 2 charges against him
            2. List of W's
          2. Hosp. has reciprocal rt. 2 get any relev. doc. from dr.'s
      6. Hrg's
        1. Arb'or /
        2. Jud'al rev. committee
          1. Three / 5 active unbiased med. members w/@ least 1 from same spec. as dr.
          2. Evid. stand. is prepond. of evid.
          3. B /p on dr. if denied applic. / on med. staff if dr. already a member but med. staff always present evid. 1st
          4. Rules of evid. relaxed so admit any evid. rsbl person would rely on conduct of serious affairs
          5. Dr.'s rt. 2 atty
            1. Det'ed by jud'al rev. committee
            2. If can't have 1, exec. committee also can't
          6. Rt. 2 written stmt & written dec. which has nexus btwn concl. & evid.
      7. Appeal
        1. Internal not req'ed: 2 bd. dir'ors of hosp.
          1. Record rev. 2 see if dec. supported by subst'l evid.
          2. Dr. has rt. 2 atty & written dec.
        2. Rt 2 jud.'al rev. after exhausting internal adm. process
          1. Writ of adm. mandamus 2 superior ct: subst'l evid. stand.
          2. Then 2 appeal & CA Sup Ct.: subst'l evid. stand.
  5. Rel. Btwn Hosp. & Dr.'s
    1. Not Ee's B/c Corp. Can't Hire Dr.'s
    2. Gen'ly Indep. K'or
      1. Dr.'s member of unincorp'ed ass'n
      2. Hosp. Based Physicians (HBP) where dr.'s not have priv. pract.
        1. Radiologist
        2. ER dr.'s
        3. Pathologist
        4. Anesthesiologist

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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