Next week the California Medical Association’s (CMA) legal counsel will testify before the California Supreme Court in the case of El-Attar v. Hollywood Presbyterian Med. Ctr.

In this case, the hospital board at Hollywood Presbyterian Medical Center ignored and overrode the medical staff executive committee's (MEC) recommendation to reappoint a physician on staff. When the physician invoked his right to a joint review committee hearing to challenge the hospital’s termination of his privileges, the hospital unilaterally appointed the hearing officer and members of the review committee. Under the medical staff bylaws, however, only the MEC has authority to determine the joint review process, including the appointment of the hearing officer and joint review committee members.

CMA, represented by CMA legal counsel and director of litigation Long Do, will argue that that the medical staff bylaws in this case must be strictly enforced in order to uphold the systemic safeguards of a fair and just peer review system. Under California and federal laws, the professionals on the medical staff have primary responsibility for all of the functions necessary to ensure patient safety and the competence of practitioners at a hospital. These functions, which include peer review, fall within the medical staff’s right to self-governance and independence. Hospital governing bodies have oversight authority, but cannot unnecessarily interfere with the medical staff’s self-governance functions, including peer review.

He will explain why the hospital in this case tipped the balance too far in its favor and how the court's ruling can have a huge negative impact on medical staff self-governance if it were to accept the hospital's arguments.

Last year, a California court of appeal had agreed with CMA's arguments and held that the hospital was wrong to unilaterally terminate the physician and then usurp the MEC’s authority to appoint the hearing officer and members of the joint review committee when the physician invoked his right to an appeal. The court relied on CMA’s model medical staff bylaws to understand the strict requirements of the medical staff’s bylaws. It also warned against the danger of sham peer reviews directed by hospital governing bodies.