Miller v. St. Alphonsus Regional Medical Center, Inc.

• Court: Idaho Supreme Court
• Writing for the Court: EISMANN, Justice.
• Citation: Miller v. St. Alphonsus Regional Medical Center, Inc., 139 Idaho 825, 87 P.3d 934 (Idaho 2004)
• Decision Date: 06 February 2004
• Docket Number: No. 28639.,28639.
• Parties: Steven J. MILLER, Plaintiff-Appellant, v. ST. ALPHONSUS REGIONAL MEDICAL CENTER, INC., a non-profit corporation and John Does 1-20, Defendants-Respondents.

87 P.3d 934

139 Idaho 825

Steven J. MILLER, Plaintiff-Appellant, v. ST. ALPHONSUS REGIONAL MEDICAL CENTER, INC., a non-profit corporation and John Does 1-20, Defendants-Respondents.

No. 28639.

Supreme Court of Idaho, Boise, December 2003 Term.

February 6, 2004.

Rehearing Denied April 6, 2004.

Jim Jones & Associates, Boise, for appellant. Jim Jones argued.

Givens Pursley, LLP, Boise, for respondent. Patrick J. Miller argued.

EISMANN, Justice.

This is an appeal by a physician from a judgment entered by the district court after a court trial dismissing a complaint seeking to force the defendant hospital to grant the physician medical staff privileges and from the award of attorney fees to the hospital under Idaho Code § 12-120(3). We affirm the judgment of the district court and award attorney fees on appeal.

I. FACTS AND PROCEDURAL HISTORY

On February 28, 1999, the plaintiff-appellant Stephen J. Miller (Dr. Miller) applied for medical staff privileges at the defendant-respondent St. Alphonsus Regional Medical Center, Inc., (Hospital), a private hospital located in Boise, Idaho, and licensed by the state of Idaho. Staff privileges permit a physician to provide medical or other patient care services in the Hospital. At the time he applied, Dr. Miller was licensed to practice medicine in the states of Washington, Alaska, Mississippi, and Idaho; he was board certified by the American Board of Surgery; he was a fellow with the American College of Surgeons; and he had been previously granted privileges at hospitals located in all states in which he was licensed to practice medicine.

The Hospital has delegated to its medical staff the authority and responsibility, among other things, of making recommendations to the Hospital's Board of Trustees (Board) concerning an application for medical staff privileges. To provide a framework to govern the functioning of the medical staff, the Board adopted "Bylaws of the Medical Staff of Saint Alphonsus Regional Medical Center" (Bylaws). Pursuant to the Bylaws, the Chair of the Surgery Department conducted an initial investigation and recommended that Dr. Miller should be granted temporary staff privileges. Effective May 13, 1999, the Hospital granted him temporary privileges "until processed through appropriate committees and final Board recommendation or 90 days whichever occurred first consistent with med. staff bylaws."

The Credentials Committee, chaired by Dr. Adcox, then began its review of Dr. Miller's application. Consistent with the Bylaws, Dr. Miller's name was posted in the doctors' lounge so that other members of the Hospital's medical staff would have an opportunity to submit written information bearing upon his application for privileges. A number of physicians contacted Dr. Adcox and advised him to carefully consider Dr. Miller's application for privileges. As a result of those contacts, Dr. Adcox made a number of telephone calls between May 18 and 24, 1999, to physicians who had previously worked with Dr. Miller. Because of negative information received in these telephone conversations, Dr. Adcox relayed the information to Sandra Bruce, the Hospital's President and CEO. She telephoned hospital administrators in Washington and Mississippi, which confirmed the substance of information obtained by Dr. Adcox. Dr. Miller was technically competent, but he was unable to work collegially with others, he was critical of others, and he exhibited serious, repeated behavioral problems in his interactions with support staff. Based upon that information, the Hospital terminated Dr. Miller's temporary privileges by letter dated May 28, 1999, which was signed by Ms. Bruce and Dr. Adcox.

The Credentials Committee met on May 26, 1999, to discuss Dr. Miller's application for privileges. As a result of various concerns, the Committee asked Dr. Adcox to conduct further investigation into the matter. The Committee met again on July 8, 1999, and during that meeting Ms. Bruce shared the information she had received during her telephone conversations with the two hospital administrators. On July 15, 1999, the Committee met with Dr. Miller. Prior to that meeting, Dr. Adcox prepared a written summary of information he had gathered in the telephone calls he had made in May. That summary omitted favorable information from those telephone calls, and some of the negative information reported in the summary was inaccurate. Dr. Adcox testified that because doctors are used to charting by exception, he included in the summary only the unexpected unfavorable information and omitted the expected favorable information. On July 21, 1999, the Credentials Committee issued a report to the Hospital's Medical Executive Committee recommending that Dr. Miller's application for privileges be denied.

Under the Bylaws, the Medical Executive Committee was required to make a recommendation to the Board, after reviewing the report from the Credentials Committee, the application for privileges, and any other related documentation or relevant information. The Medical Executive Committee could also conduct a personal interview of the applicant if it so desired. In this case, the Medical Executive Committee elected not to interview Dr. Miller, and, after considering the matter, it recommended against granting him staff privileges. Ms. Bruce gave Dr. Miller written notification of the Committee's recommendation by letter dated July 26, 1999, to which was attached the Committee's written report. That report merely adopted the report and recommendation of the Credentials Committee, which was also attached.

The Bylaws provided that an applicant could then seek review by an Ad Hoc Review Committee, which would review all prior recommendations and supporting materials and, in its discretion, could also conduct its own investigation and meet with the applicant or other individuals. It was then to make a recommendation to the Medical Executive Committee. Dr. Miller timely requested that his application be reviewed by an Ad Hoc Review Committee. The Medical Executive Committee appointed an Ad Hoc Committee consisting of four physicians, none of whom were surgeons, to review Dr. Miller's application for privileges. Dr. Miller wrote to the chair of the Ad Hoc Committee requesting that he be permitted to meet with it, but that request was denied. After reviewing the documents compiled in connection with Dr. Miller's application, the Ad Hoc Committee on September 23, 1999, recommended to the Medical Executive Committee that Dr. Miller's application for privileges be denied.

On September 27, 1999, the Medical Executive Committee met and voted unanimously, with two abstentions,¹ to adopt the report of the Ad Hoc Committee. By letter dated September 29, 1999, Ms. Bruce gave Dr. Miller written notice of the Medical Executive Committee's recommendation that his application for medical staff privileges be denied. The reason given for that recommendation was the Committee's determination that Dr. Miller had demonstrated disruptive behavior in his prior hospital affiliations and that his inability to get along with others or to rely on others for assistance and advice often resulted in poor surgical judgment and decisions, which the Committee believed had a high potential to disrupt the medical, nursing and support staff and could lead to difficulty in those individuals effectively performing their respective jobs.

The Bylaws provided that if the Medical Executive Committee made a recommendation adverse to an applicant, he or she could request a formal hearing before a panel of at least three persons appointed by the Hospital CEO. The members of the Hearing Panel had to be members of the hospital staff who had not actively participated in the consideration of the matter at any previous level, or physicians or lay people not connected with the Hospital, or any combination of such persons. Dr. Miller requested a formal hearing, and Ms. Bruce then appointed three retired physicians to serve as the Hearing Panel.

The formal hearing was conducted on January 6, 7, and 27, 2000. The Bylaws provided that the Hearing Panel "shall recommend against the person who requested the hearing unless it finds that said person has proved that the recommendation which prompted the hearing was unreasonable, not sustained by the evidence, or otherwise unfounded." On March 2, 2000, the Hearing Panel issued its report and recommendation that Dr. Miller's application for staff privileges be denied. The Panel summarized its recommendation as follows:

In four different locations in approximately seven years, the Applicant has repeatedly had significant and perhaps serious problems. There appears to be a consistent inability to evaluate with insight the dynamics of his professional environment. The Panel recognizes and appreciates the positive endorsements from a variety of sources, but these endorsements are not so persuasive as to negate the findings of the Committees. In his relatively short professional life, the Applicant has demonstrated an inability to work cooperatively with others; and the Panel believes there is a likelihood that such inability would cause problems with patient care at St. Alphonsus.

The Hearing Panel's report and recommendation was then sent to the Medical Executive Committee. After reviewing that report, the Medical Executive Committee on March 20, 2000, sent Ms. Bruce a letter stating that it affirmed its initial recommendation that Dr. Miller's application for medical staff membership be denied.

Dr. Miller then timely requested the final appeal provided in the Bylaws—an appeal to an Appellate Review Panel composed of at least three persons appointed by the Chair of the Board. The Bylaws provided that the failure to request such appellate review constituted acceptance of the adverse recommendation. Under the Bylaws, the grounds for an appeal were:

(a) There was substantial failure on the part of the Medical...