Fritz v. Huntington Hospital

• Decision Date: 08 April 1976
• Citation: 348 N.E.2d 547,39 N.Y.2d 339,384 N.Y.S.2d 92
• Parties: , 348 N.E.2d 547 In the Matter of Melvin FRITZ et al., Appellants, v. HUNTINGTON HOSPITAL, Respondent.
• Court: New York Court of Appeals Court of Appeals

Page 92

384 N.Y.S.2d 92

39 N.Y.2d 339, 348 N.E.2d 547

In the Matter of Melvin FRITZ et al., Appellants, v. HUNTINGTON HOSPITAL, Respondent.

Court of Appeals of New York.

April 8, 1976.

Irwin Littman, Merrick, for appellants.

Frank J. Mack, Huntington, for respondent.

GABRIELLI, Judge.

The principal issue is whether the rejection of the applications of petitioners, duly licensed medical doctors and osteopathic physicians, for staff membership by respondent Huntington Hospital, a privately funded not-for-profit corporation, is in violation of section 2801--b of the Public Health Law and subject to judicial review. A corollary issue is whether petitioners have standing to maintain this proceeding. Finally, if it be concluded that petitioners are entitled to judicial review and have standing, we are asked to determine whether petitioners are entitled to relief on the merits of their claims.

Petitioner Melvin Fritz, a graduate of Cornell University, was awarded a Doctor of Osteopathy from the Chicago College of Osteopathy following the successful completion of a four-year medical college program. Dr. Fritz maintains his office in Huntington, New York, approximately 10 miles away from the Syosset Hospital, Syosset, New York, where he has been granted staff privileges. It appears that 80% Of his patients reside in the area serviced by respondent Huntington Hospital.

Petitioner Ralph Levy received his baccalaureate degree Cum laude from Brooklyn College. He completed a four-year medical school course of study at the Des Moines, Iowa College of Osteopathic Medicine graduating with honors. Dr. Levy also maintains his office in Huntington, New York, and is a staff member at both the Syosset Hospital and the more distant Massapequa General Hospital. Some 85% Of his patients live in the general community area served by respondent Huntington Hospital.

Each petitioner has passed the New York State Department of Education examinations given to holders of both Medical Doctor (M.D.) and Doctor of Osteopathy (D.O.) degrees and are licensed to practice medicine and surgery in New York State. Petitioners have also completed an accredited intership program in a metropolitan area hospital which included rotational training in surgery, obstetrics, gynecology, internal medicine, pediatrics, neurology, and emergency room service.

After practicing in the community for approximately 12 years, petitioners applied for appointment to respondent's medical staff. Without otherwise addressing the merits of their applications, respondent notified petitioners that their applications were denied because they had not submitted evidence 'of meeting the established criteria of successful completion of American Medical Association approved formal training programs.' Pursuant to the procedures set forth in section 2801--b of the Public Health Law, ¹ each petitioner filed an improper practice complaint with the Public Health Council. ² Following consideration of the complaints and the response submitted by respondent, the council sent the following notice to respondent with respect to each complaint:

'(T)he Council has found cause to credit the complaint. In the Council's opinion the governing body of the hospital has not acted upon the application with legitimate or acceptable reasons stated related to standards of patient care, patient welfare, the objectives of the institution or the character or competency of the applicant.

'The governing body of the Huntington Hospital is, therefore, directed to make a prompt review of the action involved in withholding staff membership or professional privileges from Doctor Levy (and Doctor Fritz).'

Following remand and review as directed, respondent adhered to its original determination. Again, the Public Health Council expressed its disapproval of respondent's decision stating that it was 'inappropriate (for respondent) to demand an AMA approved internship and/or residency in instances in which Doctors of Osteopathy are applying for hospital privileges'.

The petition alleges that there is no difference between an American Medical Association approved training program and one concluded under the auspices of an accredited osteopathic institution and, thus, the denial of petitioners' applications was arbitrary and in violation of law. The answering affidavit submitted by respondent, on the other hand, asserts that all 243 physicians including the one Doctor of Osteopathy on the hospital staff completed American Medical Association approv programs and that the denial of staff membership to those who have not completed such a program is reasonably related to the hospital's objective of insuring the highest quality medical care for its patients, and is within its claimed judicially unreviewable discretion.

Concluding that the exclusion of petitioners from staff membership was arbitrary and contrary to the legislative policy expressed in section 2801--b of the Public Health Law, Special Term granted the petition and directed respondents to appoint petitioners to its medical staff. The Appellate Division unanimously reversed, on the law, and dismissed the petition on the ground that respondent's determination was not a proper subject for judicial interference and that petitioners did not establish that they were entitled to court-ordered staff membership under the doctrine of economic necessity and monopoly power.

Prefatorily, it should be noted that the State Department of Education has determined that the osteopathic physicians it licenses are educated, and entitled to be treated, in the same manner as other licensed physicians. As we stated in Matter of New York State Osteopathic Soc. v. Allen, 26 N.Y.2d 20, 27, 308 N.Y.S.2d 342, 346, 256 N.E.2d 510, 512:

'Osteopathic colleges are required by the Department to provide the same curriculum for their students as is required of approved and accredited medical schools, and it is expressly stipulated that they afford 'medical education which is at least equal, both in substances and in quality, to that provided in non-osteopathic schools recognized by the Board of Regents and the Department of Education.' Although they also offer their students additional training in osteopathic theory and practice, it was certainly reasonable for the Department to conclude that the educational background of these graduates of recognized osteopathic colleges was sufficient to justify recogniti of the M.D. degrees which they subsequently received.'

In support of its decision to deny petitioners staff privileges, respondent argues that since it is a privately funded hospital, it may in its sole discretion exclude any physician and its decision to do so is not subject to judicial review. There can be little doubt that at common law and until the passage of section 2801--b such was the case (Leider v. Beth Israel Hosp. Assn., 11 N.Y.2d 205, 227 N.Y.S.2d 900, 182 N.E.2d 393; Van Campen v. Olean Gen. Hosp., 210 App.Div. 204, 205 N.Y.S. 554, affd. 239 N.Y. 615, 147 N.E. 219) except perhaps where economic necessity and monopoly power were demonstrated (see Matter of Salter v. New York State Psychological Assn., 14 N.Y.2d 100, 248 N.Y.S.2d 867, 198 N.E.2d 250). However, as we pointed out in Jacobson v. New York Racing Assn., 33 N.Y.2d 144, 150, 350 N.Y.S.2d 639, 642, 305 N.E.2d 765, 767, section 2801--b of the Public Health Law effectively limited the Leider rule.

Section 2801--b is, on its face, applicable to a 'hospital', a term of art defined in subdivision 1 of section 2801 of the Public Health Law. ³ Respondent is unquestionably a 'hospital' within the meaning of section 2801--b and, therefore, is subject to the requirements and standards therein set forth, irrespective of whether it is a privately funded or public funded institution.

We turn now to the standing issue.

Section 2801--c ⁴ gives the Supreme Court jurisdiction to enjoin violations or threatened violations of article 28 which, of course, includes the improper practices detailed in subdivision 1 of section 2801--b. Respondent argues, however, that this statute neither authorizes nor confers standing upon an allegedly aggrieved physician to institute a plenary proceeding to compel his appointment to a hospital. Rather, respondent asserts, the statute gives only the Public Health Council or the State Commissioner of Health the power to request the Attorney-General to commence an action in the name of the people to enjoin any improper practices or other violations. With this concept we cannot agree.

We have recently recognized the expanding scope of standing to sue in other contexts (Matter of Dairylea Coop. v. Walkley, 38 N.Y.2d 6, 377 N.Y.S.2d 451, 339 N.E.2d 865; Boryszewski v. Brydges, 37 N.Y.2d 361, 372 N.Y.S.2d 623, 334 N.E.2d 579; Matter of Douglaston Civic Assn. v. Glavin, 36 N.Y.2d 1, 364 N.Y.S.2d 830, 324 N.E.2d 317; Matter of National Organization for Women v. State Div. of Human Rights, 34 N.Y.2d 416, 358 N.Y.S.2d 124, 314 N.E.2d 867; Columbia Gas of N.Y. v. New York State Elec. & Gas Corp., 28 N.Y.2d 117, 320 N.Y.S.2d 57, 268 N.E.2d 790) and we are guided here by our statement of principle in Matter of Dairylea (supra, at p. 11, 377 N.Y.S.2d at p. 455, 339 N.E.2d at p. 868) that '(o)nly where there is a clear legislative intent negating review * * * or lack of injury in fact * * * will standing be denied.' The first sentence of section 2801--c clearly provides without limitation or qualification, that the Supreme Court has jurisdiction to enjoin violations of the provisions of section 2801--b. While respondent argues, that the statute was not intended to confer standing upon petitioners, there is no legal precedent, statute or legislative history to support such a position and, thus, under our holding in Dairylea and other cited cases, that argument must be rejected. No legal impediment exists which would bar petitioners from seeking relief in the courts and, indeed, neither reason nor...