Fort Hamilton-Hughes Memorial Hosp. Center v. Southard

• Decision Date: 01 August 1984
• Docket Number: No. 83-50,HAMILTON-HUGHES,83-50
• Citation: 12 OBR 342,12 Ohio St.3d 263,466 N.E.2d 903
• Parties: , 12 O.B.R. 342 FORTMEMORIAL HOSPITAL CENTER et al., Appellees, v. SOUTHARD, Appellant.
• Court: Ohio Supreme Court

Page 263

12 Ohio St.3d 263

466 N.E.2d 903, 12 O.B.R. 342

FORT HAMILTON-HUGHES MEMORIAL HOSPITAL CENTER et al., Appellees, v. SOUTHARD, Appellant.

No. 83-50.

Supreme Court of Ohio.

Aug. 1, 1984.

Syllabus by the Court

R.C. 3701.351, which prohibits hospitals from discriminating in the granting of staff membership or hospital privileges, is by its terms applicable only to medical physicians, osteopathic physicians, podiatrists, and dentists.

Plaintiffs-appellees, Fort Hamilton-Hughes Memorial Hospital Center and Sisters of Mercy of Hamilton, Ohio, Inc., are private non-profit health care facilities open to members of the public. Both hospitals' bylaws provide that medical staff membership and clinical privileges will be made available to only four groups of health care practitioners: medical physicians, osteopathic physicians, dentists, and podiatrists. Applications for hospital privileges from members of these four groups are reviewed by several staff committees and then are granted or denied by the respective boards of trustees. All those who are granted privileges are subject to ongoing peer review.

Defendant-appellant, Fred M. Southard, is licensed to practice in Ohio as a doctor of chiropractic, but is not a member of one of the four groups eligible for privileges at the hospitals. Appellant has X-ray equipment sufficient for his practice, but has on occasion referred patients to the appellee hospitals for X-rays. Through clerical oversight, the hospitals have provided several X-rays and one electroencephalogram for patients referred by appellant. Upon discovery, both hospitals notified appellant that these services would not be made available to him in the future. Appellant requested that he be allowed to continue to refer patients for outpatient diagnostic services and threatened litigation if such permission were not soon in forthcoming.

Appellees filed this declaratory judgment action in the Court of Common Pleas of Butler County to determine whether the policies of the hospitals were "reasonable, proper and lawful in all respects, as against any claims, arguments or challenges of the defendant." Appellant counterclaimed, seeking a declaration as to the interpretation, applicability, and constitutionality of R.C. 3701.351, which prohibits certain types of discrimination relating to access to hospital privileges. Appellant further sought a declaration as to the lawfulness of appellees' bylaws.

The trial court rendered judgment in favor of appellees and the court of appeals affirmed.

The cause is now before this court pursuant to the allowance of a motion to certify the record.

Millikin & Fitton, Hamilton, for appellees Fort Hamilton-Hughes Memorial Hosp. Center and Sisters of Mercy of Hamilton, Ohio, Inc.

Stanley D. Rullman, Hamilton, for appellee Fort Hamilton-Hughes Memorial Hosp. Center.

James S. Irwin, Hamilton, for appellee Sisters of Mercy of Hamilton, Ohio, Inc.

Hopple, Wesp & Osterkamp, E. Joel Wesp, and Crabbe, Brown, Jones, Potts & Schmidt, Ira Owen Kane, Columbus, and Carl Morgenstern, Hamilton, for appellant.

Anthony J. Celebrezze, Jr., Atty. Gen., and Leslie A. Winters, Columbus, urging reversal for amicus curiae, State Board of Chiropractic Examiners.

Porter, Wright, Morris & Arthur, James E. Pohlman and Roberta Y. Bavry, Columbus, urging affirmance for amicus curiae, Ohio State Medical Ass'n.

Sanford, Fisher, Fahey, Boyland & Schwarzwalder Co., L.P.A., and Richard P. Fahey, Columbus, urging affirmance for amicus curiae, State Medical Bd.

Bricker & Eckler and James J. Hughes, Jr., Columbus, urging affirmance for amicus curiae, Ohio Hosp. Ass'n JAMES P. CELEBREZZE, Justice.

Central to the resolution of this cause is the interpretation of R.C. 3701.351. This statute provides in pertinent part:

"(B) The governing body of any hospital, in considering and acting upon applications for staff membership or professional privileges within the scope of the applicants' respective licensures, shall not discriminate against a qualified person solely on the basis of whether such person is certified to practice medicine or osteopathic medicine, or podiatry, or dentistry."

Appellant maintains that the statute prohibits hospital boards, in the granting of professional privileges, from discriminating against any "qualified person" solely on the basis of the applicant's class of certification. Appellees maintain that the statute merely prohibits denial of privileges to qualified members of the four enumerated groups, and does not prohibit class-wide denial of hospital privileges to other groups of health care practitioners, such as chiropractors.

The goal of statutory construction is to ascertain and effectuate the intention of the General Assembly. It is a basic doctrine of construction that the express enumeration of specific classes of persons in a statute implies that the legislature intended to exclude all others. State, ex rel. Boda, v. Brown (1952), 157 Ohio St. 368, 372, 105 N.E.2d 643. The Ohio Revised Code provides for the licensing of more than one dozen groups of health care practitioners. The fact that the legislature specifically enumerated only four of these groups in R.C. 3701.351 implies that it intended to exclude the others.

The legislature has limited the application of other enactments in the medical field to the specific licensures enumerated therein. In Whitt v. Columbus Cooperative (1980), 64 Ohio St.2d 355, 415 N.E.2d 985 , this court held that the special statute of limitations for malpractice was inapplicable to a field of practice not specifically enumerated therein. In a recent enactment, R.C. 3727.06, which provides for rights relating to the admission of patients to hospitals, the legislature specifically enumerated the same four groups specified in R.C. 3701.351.

In view of these considerations, we conclude that R.C. 3501.351, which prohibits hospitals from discriminating in the granting of staff membership or hospital privileges, is by its terms applicable only to medical physicians, osteopathic physicians, podiatrists, and dentists.

Appellant sets forth two alternative propositions of law. First, he maintains that if R.C. 3701.351 only protects the four enumerated groups, it is violative of constitutional guarantees of equal protection. As the statute does not affect a fundamental interest or suspect class, it must be upheld if there exists any conceivable set of facts under which the classification rationally furthers a legitimate governmental objective. Denicola v. Providence Hospital (1979), 57 Ohio St.2d 115, 119, 387 N.E.2d 231 . We note that the statute is intended to remedially prevent discrimination against the four enumerated groups. Dooley v. Barberton Citizens Hospital (1984), 11 Ohio St.3d 216, 465 N.E.2d 58. The legislature could have reasonably concluded that certain groups were most in need of legislative redress to ensure that they would have adequate access to the types of facilities and services essential to the performance of the particular medical services within the scope of their respective licensures. Ensuring the efficient use of health care facilities is a legitimate utilization of the police power. Since R.C. 3701.351 could reasonably further a legitimate governmental objective, it must be upheld.

Second, appellant contends that the hospitals' bylaws which preclude chiropractors, as a class, from obtaining hospital privileges are arbitrary and capricious, in violation of a fiduciary duty of hospitals to the public.

Appellees answer that the distinctions made by the bylaws are reasonable and proper because of the differences in philosophy and training between chiropractors and the four enumerated groups. The four groups utilize medicine and surgery to treat human illness and disease, whereas doctors of chiropractic rely primarily on vertebral adjustment and manipulation of the joints and adjacent tissues of the body. ¹ Appellees maintain that this difference would make it impossible for the hospitals to adequately perform peer review of chiropractors. Appellees contend that, in any event, the actions of the trustees of a private, non-profit hospital are not subject to judicial review.

A review of the record discloses that the evidence was limited to the reasonableness and effect of the bylaws as applied to appellant. The record amply supports the conclusion that appellant failed to demonstrate that access to the hospitals' services was essential to the performance of services within his personal scope of authority, or whether any such necessity would be sufficient to justify the additional burden on the hospital. The trial court specifically found that appellant possessed X-ray equipment sufficient for his practice. The record does not show that appellant's practice has in any way suffered from the denial of access to hospital privileges. So concluding, we find it unnecessary to address the availability or proper scope of judicial review of hospital bylaws. ²

For the foregoing reasons, the judgment of the court of appeals is affirmed.

Judgment affirmed.

FRANK D. CELEBREZZE, C.J., and WILLIAM B. BROWN, LOCHER and HOLMES, JJ., concur.

SWEENEY and CLIFFORD BROWN, JJ., dissent.

CLIFFORD F. BROWN, Justice, dissenting.

The declaratory judgment by the court of common pleas in this case in favor of both appellee hospitals upholding their bylaws and policies respecting the limitation of the use of radiological and laboratory services as applied to chiropractors, and its affirmance by the court of appeals, are both unreasonable and unlawful, and should be reversed, with final judgment entered granting declaratory judgment in favor of the appellant, Fred Southard, a doctor of chiropractic. The declaratory relief should invalidate the appellees' bylaws pertaining to the exclusion of chiropractors from the use of hospital diagnostic services and facilities.

Appellant is a duly qualified and licensed chiropractor. When h...