Miller v. Eisenhower Medical Center

Decision Date07 July 1980
Citation27 Cal.3d 614,166 Cal.Rptr. 826
CourtCalifornia Supreme Court
Parties, 614 P.2d 258 Donald A. MILLER, Plaintiff and Appellant, v. EISENHOWER MEDICAL CENTER, Defendant and Respondent. L.A. 31198.

Volk, Newman, Marsh, Gralla & Karp, Bruce H. Newman and James H. Karp, Los Angeles, for plaintiff and appellant.

Weissburg & Aronson, Albert C. Mour, Carl Weissburg, Patric Hooper, Robert W. Lundy, Jr., and Douglas B. Schwab, Los Angeles, for defendant and respondent.

Hassard, Bonnington, Rogers & Huber, Howard Hassard, David E. Willett and A. Robert Singer, San Francisco, as amici curiae on behalf of defendant and respondent.

MANUEL, Justice.

Plaintiff Donald A. Miller, a licensed physician and surgeon, appeals from a judgment denying his petition for a writ of mandate sought to compel defendant Eisenhower Medical Center, a private, nonprofit hospital corporation, to grant him staff membership and privileges at its hospital facility.

The cause was submitted to the trial court on the transcripts of hearings before defendant's judicial review and appellate review committees as well as various letters and documents. The underlying facts, as appearing therefrom, were in substance as follows:

Plaintiff, a board certified family physician and a member of the American Academy of Family Physicians, has been practicing in Indio, California since 1970. He first sought staff membership at the Eisenhower Medical Center, a private hospital in Palm Desert owned and operated by defendant, in 1971, but that application was subsequently withdrawn by him and he reapplied in 1972. After denial of the 1972 application he again reapplied in 1974. Again the application was denied, and plaintiff's subsequent request for a hearing pursuant to the medical staff bylaws was also denied as being untimely. 1

In 1975, plaintiff again reapplied for medical staff membership at Eisenhower. Along with this application he submitted by letter the names of 25 physicians whom the medical executive committee of the hospital might contact for recommendations concerning his suitability for membership. 2 After soliciting comments from all of plaintiff's references, 3 the medical executive committee informed plaintiff that his application has been denied "on the basis of recommendations received from references furnished by you in your letter. . . ."

Plaintiff thereupon made timely application for a hearing before the judicial review committee. (See fn. 1, ante.) He also requested copies of the recommendations upon the basis of which his application had been denied. He was provided with a compilation of the responses made to each question (see fn. 3, ante ) but was denied the names of the physicians who had provided particular responses on the ground that confidentiality was necessary "(i)n order to maintain a viable application process, . . ."

At the hearing before the judicial review committee plaintiff appeared on his own behalf; the medical-executive committee was represented by one of its members. The latter reported that plaintiff's references gave him "good support from the standpoint of your professional competence, your knowledge and (the) adequacy of your training" but that the committee felt that plaintiff "came up wanting" with respect to the opinions received on the question whether he would be an asset to the medical staff. 4 (See fn. 3, ante.) Plaintiff was permitted to present four medical doctors as witnesses on his behalf. All testified favorably regarding plaintiff's medical competence; each was of the opinion that plaintiff would be an asset to the medical staff. One indicated that he was sometimes "a little impetuous about things which he wanted to be done" concerning staff practices and procedures but that "in the long run most of these ideas were very constructive ideas." Another, responding to a question concerning possible areas of conflict in "interpersonal relationships" with others, stated that although he had heard "rumors" he had himself neither observed nor experienced any such conflicts. A third, characterizing plaintiff as "a controversial person," went on to explain that he had reference to his tendency to express himself quite forcefully and vigorously in the evaluation of the competence of another physician, for example, or the running of a medical institution.

Plaintiff was also questioned at this hearing regarding a number of other matters, including the circumstances surrounding his departure from an internship program at the Cook County (Illinois) hospital some 14 years earlier. Protesting that he had received no notice that the latter subject was to be a matter of concern at the hearing, and that therefore he was not prepared to provide an exact account of it, he nevertheless indicated that "a definite disagreement of some kind," the details of which he could not recall, had precipitated his departure from the program at Cook County Hospital and the resumption and completion of his internship at another institution.

The judicial review committee upheld the medical executive committee's decision, stating that its conclusion was based "upon the determination that sufficient doubt exists concerning Doctor Miller's ability to work with others as stated in Article III, Section 2 of the Medical Staff Bylaws." 5

Plaintiff thereupon appealed the decision of the judicial review committee to the medial center's board of trustees (board), as provided in the bylaws. 6 He requested and was granted the right to be represented by counsel at the hearing and to present witnesses in his behalf. Prior to the hearing his counsel requested that he be provided with the names of those doctors who had provided the negative recommendations reflected in the compilation previously furnished to plaintiff. Counsel for the board, responding to this request, indicated that these names would not be disclosed for reasons of confidentiality. His letter also stated: "The basis upon which Dr. Miller has been refused admission to the Medical Staff was his failure to comply with Section 2(a) of the Medical Staff By-laws and in particular, his failure to document his good reputation and ability to work with others. The following facts were presented at the hearing or will be presented at the appellate review to augment the record. (P) 1. The failure to disclose at the hearing the reasons for his termination from the internship at Cook County Hospital. This was withheld despite direct questions regarding this. (P) 2. The reasons for the termination of the residency (sic ) at Cook County Hospital which directly relate to the qualifications in Section 2(a). (P) 3. The letter from Martin S. Gittleman, Administrator of Indio Community Hospital, regarding Dr. Miller's ability to work with others. (P) 4. A letter setting forth gross inaccuracies which Dr. Miller wrote to the Comprehensive Health Planning Association which included an intemperate assault on Eisenhower Medical Center. . . . (P) 5. The existence of a sufficient number of negative comments or lack of comments on responses from Dr. Miller's references which indicate his inability to work and cooperate with others and, therefore results in his failure to meet Medical Staff requirements at the present time."

At the appellate review hearing two additional doctors were called by the medical executive committee. Each testified that plaintiff had a reputation for getting along poorly with his colleagues. One stated that he "creates dissention" and "has relatively few friends in the community," the other that he "does not get along with most members of the medical community." Neither, however, indicated that he had personally had any difficulty working together with plaintiff in the care of patients. Each of these doctors had had a prior business relationship with plaintiff: one had been associated with plaintiff in the ownership of a hospital and had particular objections concerning plaintiff's having contracted to run the emergency room at a competing hospital; the other had been associated with plaintiff in practice. Three of the four doctors who had testified in plaintiff's behalf before the judicial review committee gave substantially similar testimony at the appellate review hearing. Again none of these doctors had ever experienced any difficulty with plaintiff in mutual care of patients.

The matter of termination of plaintiff's 1961-1962 internship was also raised. A letter from the medical director of the Cook County Hospital was introduced; it was therein indicated that plaintiff had been asked to leave before the completion of his internship which was subsequently completed at another hospital, "because he did not assume his responsibilities to the hospital and his patients." Apparently a second letter from the same party was also presented, this letter explaining that the circumstances of plaintiff's dismissal involved his taking an unauthorized one-week vacation. 7 Plaintiff was examined at some length by his own and opposing counsel concerning the details of the incident and his alleged inability to recall them at the judicial review committee hearing. Again he protested that he had been given no notice of any kind prior to the latter hearing that the matter of his internship was to be raised there or had been a matter of concern to the medical executive committee in its denial of his application. 8 He indicated that he had answered "to the best of my ability but . . . just couldn't recall the exact details" at that time, "(s)ince I hadn't known that it was a problem." Having refreshed his memory in the interim by means of contacting certain parties involved, he stated that he now had a vivid recollection of the matter and was fully prepared to respond to questions concerning it. He proceeded to do so.

The medical executive committee also introduced a letter which plaintiff had directed the preceding summer to the executive director of the ...

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