Rhoads v. Stormont Vail Healthcare, Inc.
| Docket Number | 22-4005-JWB |
| Decision Date | 09 June 2023 |
| Parties | JEFFREY P. RHOADS, M.D., Plaintiff, v. STORMONT VAIL HEALTHCARE, INC., Defendant. |
| Court | U.S. District Court — District of Kansas |
This matter comes before the court on Defendant's motion for summary judgment. (Doc. 46.) The motion is fully briefed and ready for decision. (Docs. 47, 50, 51, 54.) For the reasons stated herein, Defendant's motion is GRANTED.
The following statement of facts is taken from the parties' submissions. Factual disputes about immaterial matters are not relevant to the court's determination. Therefore immaterial facts and factual averments that are not supported by record citations are omitted.
Plaintiff specializes in internal medicine and served as a hospitalist at Stormont Vail Healthcare, Inc. (“Stormont Vail” or “Defendant”). His employment was dictated by the terms of a Physician Employment Agreement (“Agreement”) dated October 1, 2019. The essential functions and duties of the hospitalist position and any inpatient or outpatient physician position include providing medical care to patients meeting the appropriate standard of care; exercising independent professional judgment related to care and treatment of patients; creating and recommending appropriate treatment plans; creating accurate and complete records of a patient's medical history; updating a patient's charts accurately and completely; leading and coordinating care of patients; and performing necessary administrative tasks. Plaintiff was required to have medical staff membership and clinical privileges to serve as a hospitalist. (Doc. 47 at 2; Doc. 50 at 2.)
The Agreement contained a provision for termination upon disability, which set out specific terms for Plaintiff's termination if he became unable to perform the essential functions of his position with or without reasonable accommodations. This provision also made clear that Stormont Vail would comply with applicable law and would “explore all reasonable accommodations, including possible reassignment, for a [p]hysician with a disability.” (Doc. 47-1 at 11.)
Stormont Vail's Medical Staff[1] is responsible for peer review credentialing, and quality and patient safety. According to Stormont Vail's credentials policy, all physicians, whether employed by Stormont Vail or not, must be granted privileges to practice at Stormont Vail. These privileges are often specific to a practitioner's specialty; for internal medicine, the specialty is a hospitalist. Dr. Kimberly Brey was President of Stormont Vail's Medical Staff during the relevant time.[2] Dr. Traci Cuevas and Dr. Jason Austin were co-medical directors of the adult hospitalist group during the relevant time. (Doc. 47-15 at 3.)
In November 2020, Dr. Cuevas called Dr. Brey to convey concerns from within the hospitalist group that Plaintiff was showing signs of dementia and to inquire about next steps to protect patients. (Id. at 4.) Dr. Austin also had concerns about Plaintiff, including a steady decline in the quality of work. Both other doctors and patients reported concerns that doctors had to start completely over when taking over a patient from Plaintiff because Plaintiff had given substandard care and failed to appropriately document or provide specific treatment plans. (Doc. 47-17 at 2- 3.) Concerns about Plaintiff Dated: least as far back as 2017, although more formal reports were not made at the time. (Doc. 54-5 at 2-3.) The concerns reported by Drs. Cuevas and Austin were consistent with the results of testing done by Plaintiff's neurologist, Dr. Ryan Townley. (Doc. 478 at 6.) Plaintiff acknowledged that if he made a mistake with a patient, it could cause the patient harm or even lead to the patient's death. (Doc. 47-18 at 8-9.)
Because of the reported concerns about Plaintiff, and per Stormont Vail's policy, Dr. Brey formed a Physicians' Health and Advocacy Subcommittee (the “Committee”) to work through concerns about Plaintiff. (Doc. 47-16 at 2; Doc. 47-19.) The Committee met and discussed Plaintiff and then recommended a temporary and precautionary restriction of Plaintiff's clinical privileges until an evaluation of his cognitive abilities could be completed. (Doc. 47-16 at 3.) Plaintiff was referred to Acumen Assessments, Inc. (“Acumen”) for evaluation. (Id.; Doc. 47-3 at 2.) Plaintiff scheduled an appointment with Acumen but was unable to be seen until January 4, 2021. (Doc. 47-3 at 2; Doc. 47-16 at 3.) Plaintiff worked his last shift as a hospitalist at Stormont Vail on November 24, 2020. (Doc. 45 at 2.)
Plaintiff began taking leave protected by the Family and Medical Leave Act (“FMLA”) on January 11, 2021. He also submitted a request for a 30-day leave of absence on January 12, 2021, which was granted. Then on February 3, 2021, Plaintiff submitted a request to the Medical Staff for a leave of absence of up to one year for health reasons. That request was also granted. (Id. at 2-3.) Plaintiff was paid his full base salary until February 10, 2021. He was paid 50% of his base salary from February 11, 2021, until the end of his FMLA leave. (Id. at 3.)
In January 2021, Plaintiff received an evaluation from Acumen which indicated “mild-moderate impairment in multiple areas of cognitive function.” (Doc. 47-3 at 5.) Plaintiff was diagnosed with Mild Neurocognitive Disorder and was not considered fit to practice medicine at that time. (Id. at 10.) Plaintiff also agreed that he likely would not be able to return to his work as a hospitalist. (Doc. 47-18 at 4-5.)
Plaintiff's appointment of clinical privileges was due to expire on August 31, 2021, and Plaintiff was required to apply for reappointment on or before that day. (Doc. 47-21 at 3-4.) Plaintiff did not reapply by that date, which is considered a voluntary withdrawal under Stormont Vail's policy. (Id.; Doc. 47-14 at 11.) In order to work as an outpatient physician at Stormont Vail, Plaintiff would have needed to apply for clinical privileges as an outpatient physician.[3] (Doc. 47-13 at 12.) Plaintiff testified at his deposition that he did not apply for those privileges because he was afraid that he would not be accepted, and if he was denied privileges, he would be reported to the Kansas Board of Healing Arts which would cause him additional problems. (Doc. 47-18 at 7.) Plaintiff additionally contends that he did not apply for outpatient privileges because he had not been offered a job as an outpatient physician. (Doc. 50 at 5-6.)
There are two branches overseeing physicians at Stormont Vail: the Medical Staff branch and the administration branch. Dr. Brey was the president of the Medical Staff. The Medical Staff made decisions regarding credentialing for physicians employed by the hospital doing inpatient work. Dr. Dishman is the Chief Medical Officer, near the top of the leadership of the administration branch. Dr. Kenagy is the President and Chief Executive Officer at the top of administration. The administration side is in charge of employment decisions, and Dr. Dishman was the decisionmaker related to Plaintiff's employment. (Doc. 47-13 at 16-17; Doc. 47-22 at 3, 8-9, 11-14.)
Before Dr. Dishman could allow Plaintiff to return to work following Plaintiff's FMLA leave, Dr. Dishman needed to know that Plaintiff could safely return to work and needed to understand what Plaintiff's capabilities and restrictions were in order to create a plan for Plaintiff's return. (Doc. 47-22 at 9-10, 15, 21.) To create a plan for Plaintiff's return and to assess what Plaintiff could safely do, Dr. Dishman asked Plaintiff to complete a fitness for duty assessment with Dr. Soni Mathew, Director of Occupational Health. (Doc. 47-23 at 3.) Dr. Dishman testified at his deposition that he was concerned about the lack of specificity as to a plan for how Plaintiff could return to work, asking questions such as what Plaintiff was able to do with and without accommodations and what hours he would be able to work. (Doc. 47-22 at 21.)
Dr. Mathew evaluated Plaintiff, reviewed his medical records, and recommended that Acumen perform an updated evaluation and provide specific recommendations as to Plaintiff's ability to perform the essential functions of his job and any necessary accommodations. (Doc. 479 at 2-3.) Plaintiff was frustrated with Dr. Mathew's recommendations. (Doc. 47-24.) Dr. Dishman discussed Plaintiff's condition with Dr. Mathew which is when Dr. Dishman determined that the further evaluation by Acumen or the University of Kansas (“KU”) was necessary. (Doc. 54-8 at 3-4.)
Plaintiff felt as if the evaluation with Acumen was complete, and he did not need to return to Acumen for further evaluation. Plaintiff declined to return to Acumen. (Doc. 51 at 24.) Dr. Brey had a conversation with Plaintiff around May 4, 2021, in which she explained to Plaintiff that she “believed the evaluation was completed as well through Acumen and [she] was not aware of a reason that he needed to be seen or evaluated by Acumen again.” (Doc. 47-35 at 4.) But Dr. Brey also reminded Plaintiff that “the issue with Dr. Matthew is from administration and they would need to answer those questions.” (Id.) Dr. Dishman offered Plaintiff two weeks of pay to be evaluated by Acumen and to work with them to come up with a solution that would allow Plaintiff to return to work, with or without accommodations. (Doc. 47-22 at 18-19.) Plaintiff declined the offer. (Doc. 47-25 at 2.)
Plaintiff and Stormont Vail continued engaging in the interactive process through their attorneys from this point forward. While engaging in the interactive process, Plaintiff's attorney admitted that Plaintiff could not return to Stormont Vail as a hospitalist, but instead requested an...
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