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MEC Investigations

MEC Investigations Lawyer  

Powers of the Medical Executive Committee (MEC)

Role and Authority

Delegation of Power: In most hospitals, the Organized Medical Staff delegates significant authority to the Medical Executive Committee (MEC). This committee often acts as an extension of the hospital’s executive branch, endorsing decisions that may be primarily business-driven. Ideally, your hospital will have an independent medical staff and MEC.

Scope of Influence: The MEC wields considerable power, including reviewing qualifications, new procedures, and equipment, as well as evaluating initial credentialing and scope of privilege applications. This body operates under state and federal laws, as well as compliant by-laws.

Primary Responsibilities

Patient Safety: The MEC prioritizes patient safety and collaborates closely with executive management to enhance the hospital’s health and profitability.

Ultimate Authority: The hospital’s governing body, typically the board of directors, holds ultimate authority and responsibility. However, many boards focus more on donations and personal benefits rather than active governance.

Investigative and Disciplinary Functions

Performance and Conduct Issues: When issues such as performance failures, medical errors, or behavioral problems arise, the MEC steps in. Investigations can be informal or formal, often lacking strict adherence to fair investigation or hearing rules.

Impact on Physicians: Physicians are highly vulnerable during MEC investigations due to two main reasons:

  1. Summary Suspension: The MEC can initiate a summary suspension.
  2. Discipline or Remediation: The MEC can recommend disciplinary actions or remediation, leaving the cumbersome peer review process as the physician’s only recourse for justice.

MEC investigations can be informal or formal. You will benefit by retaining a peer review lawyer at the earliest sign of an investigation. The best MEC lawyers focus their practice on medical license and privilege law.

You can trust the expertise of the Horowitz Medical Law Group. Led by Daniel Horowitz, recognized as the best lawyer for medical peer review cases, our team ensures that your rights are protected and that you receive fair treatment throughout the process.

What is a Medical Executive Committee

Medical Staff and the MEC

MEC Protections from a Lawsuit

Legal Protections for the MEC in California

The Medical Executive Committee (MEC) is largely protected from lawsuits related to its conduct. The “Peer Review” process is typically shielded by the California anti-SLAPP statute which means that any lawsuit against the MEC for peer review matters must be meticulously crafted. If the lawsuit is not properly written, or if an unfavorable judge reviews the case, the doctor’s case can be dismissed, and the judge may impose substantial attorney’s fees on the losing doctor.

What is the Evidence Code Section 1157 Privilege?

Read more about how medical staff and the Medical Executive Committee can affect your medical career.

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Choose Your Peers Carefully

Physicians forming partnerships and obtaining hospital privileges are usually people in love.  When they come to the Horowitz law office, they are usually out of love and getting a divorce.   When you are in the love stage try to force yourself to do a hard evaluation of the composition and day to day function of your particular MEC. What is the agenda of Medical Staff and who is really in charge?  If you smell a skunk don't be fooled if they bring you roses.

Dangers from Former “Friends” in Medical Practice

Peer review, summary suspensions, and resignations while under investigation are all triggers for license harms, primarily due to medical board reporting and National Practitioner Data Bank (NPDB) reporting. License and credentialing disclosures must include these peer review-imposed sanctions, which must be explained throughout a physician’s career. Great care must be taken, as even lesser restrictions, such as performance improvement plans (PIPs), can trigger reporting if a physician resigns during the existence of a PIP.

Your peers can quickly become your persecutors, and their conduct can easily trigger state and federal protections that grant them governmental-type powers When you sign on with a medical group or hospital, remember that you are empowering them in case of a conflict.

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New Definition as to “When” a Peer Review Investigation has Commenced

A recent development is a broadening as to when an investigation is deemed to have commenced. This can effect many rights and trigger a myriad of protections to the instigating parties.

Recently the concept of resignation under investigation received attention when a California Court greatly broadened the concept of an MEC investigation. In (Wisner v. Dignity Health (2022) 85 Cal.App.5th 35 [300 Cal.Rptr.3d 359, 370, 85 Cal.App.5th 35]) the court relied upon the NPDB Guidebook (National Practitioner Data Bank Guidebook) for determining what was or was not an “investigation”.

The court stated that “[w]e agree with the NPDB Guidebook that the definition of an investigation cannot be controlled by a hospital’s bylaws, policies, or procedures.” Until this ruling, many physician lawyers relied upon the by-laws to determine this issue of law. It made sense. The by-laws govern MEC actions and review. The by-law definitions should apply to define the term “investigation”.

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