Court invalidates hospital special privilege law

A Florida appeals court ruling preserves the validity of medical staff bylaws in a case that physicians worried could set a dangerous precedent for hospitals to use in exercising control over staff doctors.

The 1st District Court of Appeal in June invalidated a special law exclusive to St. Lucie County that allowed hospital boards' bylaws to prevail over medical staff bylaws in conflicts over medical staff privileges, quality assurance, peer review and contracts for hospital-based services.

Judges unanimously found the "St. Lucie County Hospital Governance Law" unconstitutional because it "dramatically alters" the rights and obligations agreed upon in the medical staff bylaws under a contract between the medical staff and the hospital board. Although the 2003 law applied to all hospitals in St. Lucie County, the only two medical facilities there are controlled by one corporation, Lawnwood Regional Medical Center and Heart Institute, the court said. So judges also concluded that the statute created a special privilege for Lawnwood.

"The right to contract is one of the most sacrosanct rights guaranteed by our fundamental law," the opinion states. "The substantial contract impairment imposed by this legislation was not required to protect the public health, ensure the quality of care at Lawnwood, or accomplish some other legitimate public purpose."

Stephen J. Bronis, an attorney representing Lawnwood, said the hospital is considering an appeal to the Florida Supreme Court but declined to comment further.

Still, doctors say the decision reaffirms that medical staff bylaws are a binding contract that hospitals must take seriously. "This sends a strong message nationwide to all hospitals that they can't usurp the bylaws," said Florida Medical Assn. spokeswoman Lisette Gonzalez Mariner. The FMA and the American Medical Association/State Medical Societies Litigation Center filed an amicus brief supporting the medical staff. The Litigation Center also contributed to the doctors' legal expenses.

The June ruling marks the second victory for the Lawnwood medical staff and upholds a similar trial court decision reached in March 2006.