Physician rights reaffirmed by Florida ruling

A 2008 court victory upholding the rights of the medical staff at Lawnwood Regional Medical Center may not have put an end to the decades-long battle between staff physicians and the Florida hospital. But a trial court on Dec. 30, 2009, affirmed the role of the medical staff a second time in finding that the Lawnwood hospital board violated the medical staff bylaws when it bypassed the credentials committee and decided not to renew a long-time staff member's privileges.

The committee recommended that the hospital board renew the privileges of pathologist Anil Desai, MD, who served on Lawnwood's staff for more than 12 years. Rather than following medical staff bylaw procedures for contesting such recommendations, Lawnwood board members convened a separate hearing on Dec. 9, 2009, in which they dismissed Dr. Desai, according to court records.

The physician sued the hospital, and a St. Lucie County trial judge temporary blocked Lawnwood from revoking his privileges while the case is litigated.

Not only did the hospital board's move harm Dr. Desai personally, it also created access-to-care concerns, the court said. Dr. Desai was one of only two pathologists at Lawnwood, and "allowing [his] privileges to lapse would effectively permanently remove him from the community and deprive [other] physicians and their patients of his services," Judge William Roby wrote. He added that there was no evidence that Dr. Desai was medically unqualified to remain on the medical staff.

"The medical staff bylaws are an enforceable and valid legal contract ... [and] provide a method to address such unique medical issues should they arise in the future," the court said.

The ruling reinforces a 2008 Florida Supreme Court decision validating the binding nature of medical staff bylaws, said Richard H. Levenstein, Dr. Desai's attorney. The high court case, Lawnwood v. Seeger, was sparked by an earlier dispute between the Lawnwood medical staff and hospital board. The Litigation Center of the American Medical Association and State Medical Societies and the Florida Medical Assn. supported the medical staff in the Supreme Court case.

Once again, the trial court decision "sends a message that hospitals have to comply with medical staff bylaws if they are going to take action against a physician with respect to the medical staff, and the court is going to scrutinize those decisions," Levenstein said.

Lawnwood has appealed the trial court decision in Desai v. Lawnwood to the 4th District Court of Appeal. The hospital did not respond to calls for comment.