Kansas City Professional Responsibility Defense Attorney Discusses the Revocation of Hospital Privileges In Missouri

Loss or revocation of hospital privileges can have a devastating effect on a physician’s career. The adverse impact of such a decision is felt beyond the physician and her reputation in the healing arts. Most importantly, patients suffer as well. Consequently, physicians whose privileges have been limited, suspended, or revoked by a private, non-profit hospital must vigorously fight to have their privileges reinstated. The State of Missouri now recognizes a cause of action for physicians to contest a hospital’s revocation of privileges. This cause of action is very limited in scope, as explained more thoroughly below. Professional licensing attorney Danielle Sanger zealously advocates for every professional licensee, including physicians, who have suffered an adverse action on their ability to practice their chosen profession.

The general rule in Missouri, as in most other states, is that courts will not interfere with a hospital’s decision to limit, suspend, or revoke a physician’s privileges.  The prevailing view at the time held that hospital privileges were a private matter that rested in the sole discretion of the hospital’s management. That absolute bar no longer exists and a limited exception is now recognized in Missouri. The first exception carved out of the general rule recognized a cause of action of civil conspiracy where two physicians acted in concert against a third physician to revoke privileges and steal that physician’s business. The aggrieved physician in that case was permitted to sue the hospital to be reinstated because the physician alleged something more than wrongful termination of privileges.

Subsequent to that case, Missouri adopted regulations that compel the hospital to draft and enact by-laws.  The by-laws are designed to guide the staff and promulgate the standards by which privileges are revoked, including a hearing and appellate review procedures. The state regulation created an obligation for the hospital to institute a comprehensive set of by-laws as well as a concomitant obligation to follow those by-laws. Consequently, the Missouri Supreme Court recognized the narrow exception to the general rule permitting a physician to sue a hospital for injunctive relief compelling the hospital to follow its own by-laws prior to revoking privileges. In that case, the Missouri Supreme Court indicated a trial court in a suit for injunctive relief would scrutinize the hospital’s actions to ensure “substantial compliance with the hospital’s by-laws.”  Substantial compliance, however, is not a re-evaluation of the hospital’s case. Rather, substantial compliance means that a reviewing court will analyze whether the hospital followed its own by-laws regarding the decision that adversely affects a physician’s privileges. A court will not order injunctive relief if the hospital has complied.

While Missouri courts recognize a suit for equitable relief against a hospital for failure to comply with its by-laws, they have thus far refused to permit a suit for money damages against the hospital.  In Missouri, the hospital’s by-laws are not considered a contractual obligation to a physician. Likewise, privileges to practice at a hospital are not absolute. Privileges may be revoked for reasons which are non-discriminatory and reasonable according to the hospital’s rules and regulations. The rationale supporting this rule relates back to the ultimate mission of a hospital: quality patient care. Missouri courts have reasoned that hospitals should not be forced to make financial decisions relating to restricting privileges at the risk of patient care.

The general rule does not appear to be expanding beyond those limited exceptions. In a recent Missouri case, a physician brought suit for tortious interfere with business expectations. The trial court dismissed and the appellate court upheld that decision, thereby refusing to extend relief beyond injunctive already recognized by Missouri courts.

Contact An Experienced Professional Licensing Attorney For Immediate Assistance

Contact Kansas City Professional Responsibility Defense Attorney Danielle Sanger immediately if you have received notice of a potential adverse action against your privileges. Getting an experienced professional licensing attorney involved early in your case may make the difference to you, your business, and most importantly, your patients. Call professional licensing attorney Danielle Sanger at 785-979-4353 today for a free, no-obligation consultation.

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