Laird v. Board of Trustees of Institutions of Higher Learning of State of Miss.

• Decision Date: 22 December 1983
• Docket Number: No. 82-4485,82-4485
• Citation: 721 F.2d 529
• Parties: 14 Ed. Law Rep. 896 Kermit D. LAIRD, M.D., D.C. Strange, M.D., Russell Lyle, M.D., et al., Plaintiffs-Appellants, v. The BOARD OF TRUSTEES OF the INSTITUTIONS OF HIGHER LEARNING OF the STATE OF MISSISSIPPI, Defendant-Appellee.
• Court: U.S. Court of Appeals — Fifth Circuit

Page 529

721 F.2d 529

14 Ed. Law Rep. 896

Kermit D. LAIRD, M.D., D.C. Strange, M.D., Russell Lyle, M.D., et al., Plaintiffs-Appellants, v. The BOARD OF TRUSTEES OF the INSTITUTIONS OF HIGHER LEARNING

OF the STATE OF MISSISSIPPI, Defendant-Appellee.

No. 82-4485.

United States Court of Appeals, Fifth Circuit.

Dec. 22, 1983.

Gholson, Hicks & Nichols, Hunter M. Gholson, Columbus, Miss., for plaintiffs-appellants.

Ed David Noble, Jr., Jackson, Miss., William Ward, Starkville, Miss., for defendant-appellee.

Appeal from the United States District Court for the Northern District of Mississippi.

Before CHARLES CLARK, Chief Judge, GOLDBERG and POLITZ, Circuit Judges.

GOLDBERG, Circuit Judge:

Plaintiffs in this case challenge a Mississippi State University policy that allows university employed physicians to use campus facilities in their private practice. The challenge rests on the Fourteenth Amendment's Equal Protection Clause and Mississippi State law. Because we believe that the district court correctly found that the challenged policy bears a rational relationship to a legitimate state interest, we affirm its dismissal of the equal protection challenges. We also find that the district court acted within its discretion in dismissing the pendent state claims.

I. BACKGROUND

A. Facts

Plaintiffs are all practicing physicians in Oktibbeha County, Mississippi. Defendant, the Board of Trustees of the Institution of Higher Learning of the State of Mississippi ¹ (the "Board") controls eight state universities, ² including Mississippi State University ("MSU"). Since its creation the Board has adopted certain general policies to which all state universities adhere, but has delegated to each university the determination of various administrative procedures. Individual university discretion extends to the scope and sophistication of on-campus student health services. The services offered, in fact, vary from twenty-four hour physician, nursing and hospital coverage at MSU to part-time infirmary coverage at certain other state universities. Annual student health services costs range from a high of $60.00 per student at MSU to a low of $26.00 per student at the University of Southern Mississippi.

MSU employs four doctors in order to maintain its twenty-four hour services to students. All four of the physicians use university student health facilities to examine and treat private patients. Most, but not all of these private patients have connections to the university. The Director of MSU's Student Health Service and the Board contend that this on-campus private practice aids in maintaining desired levels of student medical care and student medical coverage. Record at 96. The plaintiffs in this case assert that the MSU on-campus, private practice policy competitively disadvantages them in attracting patients and hiring employees.

B. Procedure Below

Plaintiffs brought a section 1983 ³ action in district court asserting that Board approved, on-campus private practice violates equal protection in two ways. One purported violation rests on defendant's actions in allowing MSU employed physicians to use campus facilities while excluding plaintiffs; the second derives from the fact that the private medical practice permitted at MSU is not allowed at other state universities. Plaintiffs also asserted a pendent state law claim that the Board's actions in permitting private use of state property conflicts with the Constitution and laws of the State of Mississippi. The complaint sought declaratory relief and an injunction to prohibit defendant and its agents from allowing the use of state university facilities in private medical practice.

On cross motions from summary judgment, the district court dismissed the equal protection claims on their merits. In ruling against the claim of unconstitutional discrimination between plaintiffs and MSU physicians, the court deferred to defendants' arguments that allowing physician employees to pursue private practice on campus enabled MSU to pay comparatively low salaries, broadened the professional skill of the physicians, and kept the physicians on campus for longer hours. Finding a rational relationship between MSU's on-campus, private practice policy and the state's interest in providing high quality medical services to MSU students, the court found no violation of equal protection. The court dismissed the second equal protection claim because it found plaintiffs lacked standing to complain that on-campus private practice is not permitted at state universities other than MSU. The district court refused to decide pendent claims because complex and unresolved state law issues were involved, because more in depth briefing would be needed to resolve those issues, and because the federal claims had been dismissed. The state claims were dismissed without prejudice so that they could be brought before the appropriate state court.

C. Issues On Appeal

All three of the district court's basic rulings are before this court on appeal. Plaintiffs contend that the district court mistakenly concluded that defendant met the "rational relationship" standard. Plaintiffs also assert that the district court's dismissal of one of the equal protection claims for lack of standing was error. Finally, plaintiffs argue that dismissal of the pendent claims constituted abuse of discretion.

II. EQUAL PROTECTION--PLAINTIFFS AND MSU EMPLOYEE PHYSICIANS

As noted above, one of plaintiffs' equal protection claims centers on the challenged policy's discrimination between MSU employee physicians and plaintiffs. The Supreme Court made painfully ⁴ clear in City of New Orleans v. Dukes, 427 U.S. 297, 303, 96 S.Ct. 2513, 2516-2517, 49 L.Ed.2d 511 (1976), the correct level of scrutiny for state policies like the one involved here.

Unless a classification trammels fundamental personal rights or is drawn upon inherently suspect distinctions such as race, religion, or alienage, our decisions presume the constitutionality of the statutory discriminations and require only that the classification challenged be rationally related to a legitimate state interest.

Plaintiffs, not claiming that they are members of a protected class or that the practice of medicine constitutes exercise of a fundamental right, agree that the "rational relationship" standard is appropriate. They further admit that the asserted state interest in "good student health care" is legitimate. Plaintiffs challenge to MSU's private practice policy rests on their contention that the policy is not rationally related to good student health care.

In making such a challenge, plaintiffs must shoulder a heavy burden as explained in Kite v. Marshall, 661 F.2d 1027, 1030 (5th Cir.1981), cert. denied, 457 U.S. 1120, 102 S.Ct. 2934, 73 L.Ed.2d 1333 (1982).

A state action viewed under the rational basis banner is presumed to be valid. In such a situation, the burden is not upon the state to establish the rationality of its restriction, but is upon the challenger to show that the restriction is wholly arbitrary.

Pappanastos v. Board of Trustees of the University of Alabama, 615 F.2d 219, 221 (5th Cir.1980), states that the court's task is to inquire whether "any state of facts may be conceived to justify" the challenged policy. We must, therefore, examine the justifications defendant asserts for allowing its employee physicians to use campus facilities for private practice. The inquiry is an abbreviated one, though, for we have to look no further than to the challenged policy's basic function. Discriminating between doctors who work for the university and those who don't is simply part of MSU's method of compensating its employees. That a rational relationship exists between compensating doctors and running a medical care program can hardly be challenged.

Aside from their complaint that MSU discriminatorily bestows benefits upon its employee physicians, plaintiffs can also be heard to complain about the particular nature of those benefits. Plaintiffs assert that MSU's in-kind compensation of its doctor employees gives those doctors a special competitive advantage with respect to private practice. Such a claim, however, does not fall within the purview of the equal protection clause. Having found that MSU's compensation scheme constitutes a rational effort to promote a student medical care program, we can look no further. ⁵ Even if MSU could compensate its doctor employees in a manner that was equally effective but less disadvantageous to plaintiffs, "we cannot impose upon the state our view of what may constitute the fairest or most rational scheme." Alford v. City of Lubbock, Texas, 664 F.2d 1263, 1267 (5th Cir.1982), cert. denied, 456 U.S. 975, 102 S.Ct. 2239, 72 L.Ed.2d 848 (1982); see also Dandridge v. Williams, 397 U.S. 471, 485-87, 90 S.Ct. 1153, 1161-1162, 25 L.Ed.2d 491 (1970). As pointed out in City of New Orleans v. Dukes, supra, 427 U.S. at 303, 96 S.Ct. at 2516-2517,

the judiciary may not sit as a superlegislature to judge the wisdom or desirability of legislative policy determinations made in areas that neither affect fundamental rights nor proceed along suspect lines. ⁶

III. EQUAL PROTECTION--PLAINTIFFS AND PHYSICIANS IN OTHER MISSISSIPPI COMMUNITIES

Plaintiffs' other equal protection claim centers on their assertion that only MSU among the eight state universities allows such a significant degree of on-campus, private practice. This policy produces an impermissible classification, according to plaintiffs, inflicting competitive disadvantage on doctors practicing near MSU while not harming doctors in other state university communities. Again, the rational relation test is appropriate; again plaintiffs' claim fails. We have little problem in conceiving of a "reasonable state of facts" to justify defendant's practice, Pappanastos, supra, 615 F.2d at 221, of giving each university discretion in establishing the operating levels and administrative...