Do Doctors Have Due Process Rights in Peer Review Hearings?

Doctors Have Due Process Rights

California courts have long recognized that once a physician is granted medical staff privileges, those rights become vested. This landmark principle, established in cases like Anton v. San Antonio Community Hosp. (1977), dictates that a physician cannot be denied reappointment without a fair process. This "minimal due process" includes essential safeguards such as:

• A hearing before the deciding board: Physicians have the right to present their case directly to the body making the decision about their privileges.
• A written statement of charges: The reasons for the proposed termination must be clearly outlined in writing, ensuring the physician understands the allegations.
• The right to call witnesses: Physicians can present their own witnesses to support their defense and provide context.

California Law Codifies These Rights:

In 1989, the California Legislature formally incorporated these due process requirements into the Business and Professions Code section 809 et seq. This legislation mandates a comprehensive procedure that acute care hospitals must include in their bylaws when considering adverse actions against staff physicians.

Key aspects of this legal framework include:

• Written Notice of Proposed Action: If a peer review body (comprised of medical staff members) proposes a "final proposed action" against a physician, the physician is entitled to written notification. This notice must detail their right to request a hearing.
• Right to a Hearing: Physicians facing a final proposed action have the right to a formal hearing.
• Procedural Rights During the Hearing: This hearing must afford the physician crucial rights, including:
  • The ability to call, examine, and cross-examine witnesses.
  • The right to present their own evidence.
  • The opportunity to rebut any evidence presented against them.
• Written Decision and Appeal Information: Following the hearing, the physician is entitled to a written decision outlining the outcome and information about any available appeal process.

Governing Bodies Also Held Accountable:

Interestingly, the law also addresses situations where a hospital's governing body (like a board of directors) directs a peer review body to take action, but the peer review body fails to do so. In such cases, the governing body can step in and take action directly against the physician. However, even in these circumstances, the governing body must fully comply with the same procedural rights outlined in Business and Professions Code sections 809.1 to 809.6.

In Conclusion:

The legal landscape in California strongly protects a physician's right to due process when facing the potential termination of hospital staff privileges. Whether the action originates from a peer review body or the hospital's governing body, physicians are entitled to fair procedures, including clear notification of charges, the opportunity for a hearing, the right to present evidence and witnesses, and a written decision. Understanding these rights is crucial for any physician facing such challenging circumstances.

Daniel Horowitz is a physician defense lawyer who represents doctors facing license challenges, peer review, credentialing and discipline issues.