Decisions about hospital staff privileges: a case for judicial deference.

Abstract

The refusal of a hospital to grant medical staff membership and clinical privileges is, generally, subject to judicial review. Because a hospital can be held liable for negligence in the selection and retention of medical staff members, and because a hospital is better situated than a court to make a decision concerning staffing needs, courts should, and generally do, afford great deference to the appointment decisions of hospital governing boards and medical staffs. An analysis of selected cases involving judicial review of hospitals selection and retention of medical staff members will be instructive in reviewing judicial deference to hospital governing boards.When a physician who has been denied medical staff membership and clinical privileges by a hospital seeks judicial review, the court generally first determines whether the hospital is private or public. This distinction frequently determines the outcome. The activity of a public hospital, as a governmental entity, is deemed state action. Under the fifth and fourteenth amendments to the Constitution, neither a state nor the federal government can deprive a person of life, liberty, or property without due process of law.