Pinsker v. Pacific Coast Society of Orthodontists

Decision Date20 September 1974
Citation116 Cal.Rptr. 245,526 P.2d 253,12 Cal.3d 541
CourtCalifornia Supreme Court
Parties, 526 P.2d 253 Leon J. PINSKER, Plaintiff and Appellant, v. PACIFIC COAST SOCIETY OF ORTHODONTISTS et al., Defendants and Respondents. L.A. 30228. In Bank

Emanuel Gyler and Gyler & Gottlieb, Long Beach, for plaintiff and appellant.

Hassard, Bonnington, Rogers & Huber, San Francisco, Overton, Lyman & Prince, Fred S. Lack, Jr., Los Angeles, and Richard G. Logan, Oakland, for defendants and respondents.

TOBRINER, Justice.

Dr. Leon Pinsker, a licensed dentist specializing in orthodontics, commenced this action in August 1962, contending that the defendant orthodontist societies 1 had arbitrarily rejected his application for membership. In the initial phase of these proceedings, defendants contended that because membership in their association was not an 'economic necessity' for Dr. Pinsker, the organizations' admission decisions were not properly subject to judicial review even if Pinsker had been arbitrarily or capriciously excluded. The trial court granted judgment for defendants, but on appeal our court reversed, concluding that '(b)ecause of the unique position in the field of orthodontics occupied by defendant . . . organizations . . . a public interest is shown, and the associations must be viewed as having a fiduciary responsibility with respect to the acceptance or rejection of membership applications.' (Pinsker v. Pacific Coast Soc. of Orthodontists (1969) 1 Cal.3d 160, 166, 81 Cal.Rptr. 623, 627, 460 P.2d 495, 499.)

We held that 'an applicant for membership has a judicially enforceable right to have his application considered in a manner comporting with the fundamentals of due process, including the showing of cause for rejection.' (Id.) We remanded the matter to the trial court to afford defendants an opportunity to demonstrate that they had met these requirements in rejecting Dr. Pinsker's membership application.

On remand, defendants based their exclusion of Dr. Pinsker on the ground of his continuing violation of one of the societies' 'Principles of Ethics,' a provision prohibiting an orthodontist from 'delegating to a person less qualified any services or operation which requires the professional competence of an orthodontist.' Dr. Pinsker challenged the defendants' position on three grounds: first, he contended that under any reasonable interpretation of the rule his conduct did not violate it; second, that even under the societies' interpretation of the rule he committed no violation; and third, that in any event the societies rejected his application arbitrarily because they did not give him an opportunity to respond to the charges against him.

The trial court ruled in favor of defendants, upholding the societies' interpretation of the rule, and concluding that on the basis of the evidence Dr. Pinsker had indeed violated it. Although the court recognized that the societies had not afforded Dr. Pinsker an opportunity to respond to the charges or a hearing of any sort, the court held that precedent called for no such opportunity.

As discussed below, we have decided that in rejecting Dr. Pinsker's application, defendant societies failed to comply with the minimal requisites of a fair procedure required by established common law principles. As our past cases recognize, an organization's decision to exclude or expel an individual may be 'arbitrary' either because the reason for the exclusion or expulsion is itself irrational or because, in applying a given rule in a particular case, the society has proceeded in an unfair manner. Although the fair procedure required in this setting clearly need not include the formal embellishments of a court trial, an affected individual must at least be provided with some meaningful opportunity to respond to the 'charges' against him.

We have further concluded that in reconsidering Dr. Pinsker's application, defendants may validly impose the nondelegation rule and may properly reject his application if he has in fact continued to share patients with a dentist who lacks the requisite educational qualifications for membership in defendant societies.

1. The facts.

Dr. Pinsker obtained a general license to practice dentistry in California in 1953 and began his practice in this state the following year. In 1956, Pinsker formed a partnership in the City of Long Beach with Dr. Max Schleimer, a dentist who since 1954 had limited his practice to orthodontics; thereafter, both Pinsker and Schleimer practiced only orthodontics. California does not provide for the separate licensing of specialists in the field of orthodontics and thus all licensed dentists can legally practice this specialty.

In 1958, Pinsker enrolled in a 16-month post-graduate course at Columbia University Division of Orthodontics in New York City. He successfully completed the course in January 1960, and received a Certificate of Training in Orthodontics, the rough equivalent of a master's degree. In May 1959, while still at Columbia, Pinsker submitted an application for membership to the local society. 2 In the fall of 1959, before Pinsker returned from New York, a member of the local society, Dr. Spears, visited the offices of Pinsker and Schleimer at the request of the chairman of the local society's membership committee, and wrote a brief note to the chairman listing the personnel employed at the officers. 3

Several months thereafter, in April 1960, Spears discussed his visit to Pinsker's office at a meeting of the local society's membership committee, reporting that Pinsker had a partnership arrangement with Dr. Schleimer, who was not a member of defendant organizations and who did not possess the requisite post-graduate course work then required for eligibility. Dr. Cottingham, the chairman of the local membership committee, testified that at approximately the same time he received information from another society member, Dr. Donaldson, indicating that Pinsker and Schleimer 'shared' patients, that is, each worked on all the patients who came into the office.

At trial Dr. Cottingham explained that the committee members felt that if Pinsker were permitting Schleimer to perform orthodontic work on Pinsker's patients, Pinsker would probably be in violation of section 3 of the association's 'Principles of Ethics,' which provided in part: 'The orthodontist has an obligation to protect the health of his patient by not delegating to a person less qualified any service or operation which requires the professional competence of an orthodontist.' The members interpreted the phrase 'person less qualified' to include a licensed dentist who did not have the requisite educational qualifications to be eligible for membership in their societies; thus, if Pinsker were sharing patients with Schleimer, they believed that he would be improperly delegating work to a 'person less qualified.'

As a result of the questions raised at the meeting, Dr. Cottingham wrote a letter to Pinsker on May 2, requesting a clarification of his partnership practice. This letter, however, did not specify the society's particular concern but simply requested, in general terms, that Pinsker 'give a description of your practice, the number and status of your partners or associates and copies of your office stationery.' 4 Pinsker responded on May 9, 1960, disclosing that he had 'been engaged in the exclusive practice of orthodontics since January of 1957, with my partner Dr. Max Schleimer.'

On May 11, 1960, the local membership committee again met and formally took up Pinsker's application for association membership. Pinsker was given no indication that he might be in violation of the societies' non-delegation rule and no opportunity either in writing or in person to present his side of the story. On the basis of the limited information before it, the membership committee voted unanimously to reject Pinsker's application on the ground that he was engaged in a patient-sharing practice which constituted a violation of the nondelegation rule.

Shortly thereafter, Dr. Neff, the secretary of the local society, informed Pinsker that his membership application had been denied. Pinsker at first unsuccessfully sought an explanation of the reason for the society's denial but ultimately found it lay in his alleged sharing of patients with Dr. Schleimer. Pinsker testified that he discontinued this practice in late July 1960.

In June 1960, after Pinsker had questioned the basis for his rejection, the local society rescinded its initial rejection of Pinsker and notified him that his application had been reinstated and that he would 'hear the outcome . . . in the near future.' Months later, on January 9, 1961, the local society, after some communication with the regional and national societies, considered Pinsker's application for a final time. Pinsker was not afforded an opportunity either to appear in person or submit a written statement on his own behalf for consideration at the meeting.

Aside from the information which had been related eight months earlier by Dr. Spears and Dr. Donaldson, the only information before the committee on January 9 consisted of a report by Dr. Neff on a conversation that he had had with two orthodontists 'while waiting for lunch' earlier that same day. In his deposition 5 Dr. Neff recalled the conversation as followss 'I asked Dr. Shannon and Dr. Jensen, both of whom practice in Long Beach, if they still knew whether Dr. Pinsker still employed these two dentists. 6 Both replied that they were certain that at least one was still there.' This statement, of course, indicates only that Pinsker and Schleimer were still in practice together in January 1961, and does not establish that Dr. Shannon or Dr. Jensen knew whether the dentists' 'patient-sharing' procedure had continued. Nevertheless, on the basis of the foregoing matter, the local society decided to reject Pinsker's application for membership.

On January 23,...

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