Who Is in Charge of Our Hospitals?

By: Barry S. Landsberg | Joanna S. McCallum
– Daily Journal

Literally, no one wants to "go there." We just want to know that physicians and hospitals are providing quality care. For decades, however, a debate has raged within hospitals for primacy over responsibility for deciding whether a physician's privileges to treat hospital patients should be curtailed or terminated. What role does the medical staff, consisting of independent contractor physicians, play? What role does the hospital's board, consisting of mostly nonphysician community leaders, play? What happens when the medical staff declines to discipline a problem physician, whether for fear of liability to the physician, or because physicians simply are reluctant to judge a peer?

California law confirms it is the hospital's board that bears ultimate responsibility for the safety of patients and the quality of care in the facility, although medical staffs must ensure effective physician oversight, including peer review. /Hongsathavij v. Queen of Angels/Hollywood Presbyterian Medical Center/, 62 Cal. App. 4th 1123, 1143 (1998). A hospital may be held liable to patients if it negligently allows problem physicians to practice there. /Elam v. College Park Hospital/, 132 Cal. App. 3d 332, 346 (1982).