In a ground breaking and precedent setting case, a July court settlement regarding California’s Tulare Regional Medical Center (TRMC) marks a resounding win for medical staff self-governance. The settlement reinstates—with all of its rights, privileges, and status—the organized medical staff that was fired and replaced, and the hospital has agreed to pay $300,000 for the TRMC medical staff’s legal expenses.
The case is a major legal milestone for the nation as a whole. Hospital administration and medical staff governance are often a loggerheads about many issues. Ultimately the board of trustees approves or disapproves major issues when presented by either group, because they are the fiduciary representatives.
Some background information.
Medical staff organizations are typically free-standing organizations with their own bylaws and regulations. This allows the physicians to act independently from hospitals and their owners allowing them to make independent decisions directing quality of care for patients. This provides a direct route from physicians to patients when there are disputes with hospital management.
Such a conflict arose at Tulare Regional Medical Center, a Tulare County District Hospital, several years ago.
The suit was filed after the hospital’s board of directors voted Jan. 26, 2016, to terminate the medical staff organization, remove elected medical staff officers, install a slate of appointed officers and approve new medical staff bylaws and rules without staff input.
At the time, CMA legal counsel and litigation director Long Do said the case represented “an existential threat to independent hospital medical staffs.”
The hospital eventually filed for bankruptcy and closed its doors. None of the current members of the hospital’s board of directors were members of its board during the events that were in dispute.
In the settlement, TRMC has agreed to:
- Not recognize the replacement staff, its leaders or bylaws.
- Reinstate the original medical staff, its duly-elected officers, with all the privileges, rights and status that existed before the Jan. 26, 2016 termination.
- Reinstate the pre-existing medical staff bylaws, rules, and policies.
- Pay $300,000 for the TRMC medical staff’s attorneys’ fees and costs.
- Waive all rights to appeal or challenge the settlement’s validity.
Milestone Event: HCCA out of Tulare Regional Medical Center
The hospital is now seeking a new operator and financing to reopen it's doors. The medical staff must now be reconstituted.
The effect on the community was devastating.
California settlement a big win for medical staff independence | AMA Wire:
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