Davidson v. Youngstown Hospital Ass'n

• Decision Date: 16 September 1969
• Citation: 19 Ohio App.2d 246,250 N.E.2d 892
• Parties: , 48 O.O.2d 371 DAVIDSON et al., Appellants, v. YOUNGSTOWN HOSPITAL ASSOCIATION, Appellee.
• Court: Ohio Court of Appeals

Page 246

19 Ohio App.2d 246

250 N.E.2d 892, 48 O.O.2d 371

DAVIDSON et al., Appellants, v. YOUNGSTOWN HOSPITAL ASSOCIATION, Appellee.

Court of Appeals of Ohio, Seventh District, Mahoning County.

Sept. 16, 1969.

Syllabus by the Court

1. A private, nonprofit, hospital which receives part of its funds from public sources and through public solicitation, which receives tax benefits because of its nonprofit and nonprivate aspects, and which constitutes a virtual monopoly in the area in which it functions, is a 'private hospital' in the sense that it is nongovernmental, but it is in no position to claim immunity from public supervision and control because of its private nature. The power of the staff of such a hospital to pass on staff membership applications is a fiduciary power, which must be exercised reasonably and for the public good.

2. Any rule or regulation of a professional society which has the effect of depriving an individual of an opportunity for earning a livelihood in a profession in which he is duly licensed by the state is subject to judicial scrutiny to determine whether it is arbitrary and unreasonable.

3. The managing authorities of a private hospital are vested with broad discretionary powers in the selection of its medical and surgical staffs. If the exclusion of a person from its medical or surgical staff is based on sound and reasonable exercise of discretionary judgment, courts will not intervene, but if the exclusion stems from unreasonable, arbitrary, capricious or discriminatory considerations, equitable relief is available.

4. The managing authorities of a hospital, whether public or private, under the power to adopt reasonable rules and regulations for the government and operation thereof, in the absence of any statutory restriction, may prescribe the qualifications of physicians and surgeons for admission to practice therein, and may adopt and enforce reasonable regulations concerning the qualifications of practitioners to engage in particular kinds of practice, or to perform particular kinds of operations, and also concerning the conditions under which operations, or particular kinds of operations or other services, may be performed.

Dennis Haines and Green, Schiavoni, Murphy & Stevens, Youngstown, for appellants.

Eldon S. Wright and Harrington, Huxley & Smith, Youngstown, for appellee.

LYNCH, Presiding Judge.

This appeal concerns the questions of whether Youngstown Hospital Association, a private nonprofit charitable corporation, has the discretionary power to exclude licensed podiatrists from its staff and, in so excluding the plaintiffs, of whether it acted arbitrarily, unreasonably, capriciously and discriminatorily.

At the time of the trial in December, 1966, Section 4731.51, Revised Code (128 Ohio Laws 57, 58), provided as follows:

'The practice of chiropody (podiatry) consists of the treatment of ailments of hand or foot, non-systemic in character, and the treatment of muscles and tendons of the lower leg governing the functions of the foot. It shall also include the making of molds or casts of the foot or any part thereof for the purpose of fitting or prescribing appliances, devices, or shoes for the correction or relief of foot ailments.

'Certificates authorizing the practice of chiropody (podiatry) permit examinations and diagnosis of the appropriate parts but do not confer the right of operative procedures upon the hands or feet for conditions requiring the use of general anaesthetics. In practice, chiropodists are permitted the use of local antiseptic preparations and local anaesthetics, analgesics, and antibiotics. The use of x-ray or radium for therapeutic purposes is not permitted.'

Plaintiffs, appellants herein, are experienced licensed podiatrists. They made application for hospital privileges or staff membership to the Youngstown Hospital Association, which were denied on the basis of the following recommendation of its Credentials Committee:

'The Credentials Committee of the Youngstown Hospital Association recommends that podiatrists not be granted staff privileges. The surgical procedures requested by the podiatrist representative are adequately done by the present surgical staff on both private and clinical patients. On the ward podiatry services are available to patients in the Youngstown Hospital. The staff physicians must request service by written order on the patient's chart. The Joint Commission on Accreditation of Hospitals has stated that a podiatrist must be under the jurisdiction of the Department of Surgery and that the podiatrist be under the direct supervision of a physician. By supervision is meant that during an operation a staff surgeon must be present in the operating room gowned and scrubbed as the responsible person. In other hospitals this is (sic) (has) not worked out since none of the staff surgeons would accept the responsibility for supervision of surgery performed by the podiatrist. A podiatrist is not permitted by law to take care of complications, such as the need for amputation. This would complicate the proper care of the patient with increased liability to the hospital.'

The rule of the Joint Commission on Accreditation of Hospitals on hospital privileges of podiatrists is as follows:

'A hospital staff may vote a licensed podiatrist privileges in his specialty. Each hospital staff must evaluate the qualifications of each podiatrist who applies for hospital privileges. The degree of privileges accorded each podiatrist must be determined by his actual professional experience, competence and ability, and his demonstrated character and judgment.

'A licensed physician and surgeon who is a member of the active staff of the hospital must assume responsibility for a patient's total care. The rules and regulations of the hospital must insure that this responsibility will attach at the time of admission and will continue throughout the period of hospitalization. When a surgical procedure is to be performed on a patient by a podiatrist, a physician-surgeon who has been granted surgical privileges by the hospital must assume responsibility for said procedure and the nature and degree of the physician-surgeon's participation is a matter for his determination, subject to the rules of the hospital.

'The podiatrist may write orders within the scope of his license as limited by the applicable statutes and the hospital regulations.'

Plaintiffs' petition for a mandatory order to compel the Youngstown Hospital Association to grant them hospital privileges and to admit them to its staff was denied by the trial court, and plaintiffs' appeal is before us on questions of law.

Plaintiffs' first assignment of error is that the trial court erred in finding that the Youngstown Hospital Association, as a private hospital, has the absolute right and discretion to exclude licensed physicians and other medical practitioners from its staff, and that the courts of Ohio have no judicial power to review such action by the association.

The trial court's decision is based on the authority of State ex rel. Sams v. Ohio Valley General Hospital Assn., 149 W.Va. 229, 140 S.E.2d 457. See, also, Shulman v. Washington Hospital Center, D.C. 222 F.Supp. 59.

In Sams v. Ohio Valley General Hospital Assn., D.C., 257 F.Supp. 369, the federal District Judge held that the allocation of Hill-Burton funds to West Virginia hospitals by the state agency responsible for allocating and administrating federal grants constituted 'state action' as to give the federal district court jurisdiction of action by medical doctors who asserted that hospitals' refusal to grant them staff privileges constituted such discrimination...