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Medical Staff Privileges

Physician can obtain peer review proceedings - State ex rel. Health Midwest Development Group, Inc. v. Daugherty, 965 S.W.2d 841 (Mo. 1998)

Guide to State ex rel. Health Midwest Development Group, Inc. v. Daugherty, 965 S.W.2d 841 (Mo. 1998)

Manit Vajaranant, M.D.'s hospital privileges were suspended, citing concerns about his obstetrical care. After peer review proceedings, the doctor's privileges were initially restricted but later fully reinstated. Dr. Vajaranant and his spouse sued Health Midwest Development Group, Inc. During discovery, they sought peer review committee documents.  The circuit Judge ordered Health Midwest to produce one hospital's peer review documents. The hospital sought a writ of prohibition, and the Court of Appeals, Western District, issued it. The Supreme Court granted transfer.

Court en banc holds: (1) At common law, there is no privilege for documents of peer review committees.

(2) Section 537.035.4 contains a privilege for peer review committees, but section 537.035.5 nullifies 537.035.4 when, as here: 1) an entity that formed the peer review committee 2) is sued for the committee's actions 3) that restrict a physician's hospital staff privileges.

(3) Since privileges are impediments to the truth, and statutes creating them are narrowly construed, the peer review privilege in section 537.035 does not apply at all when an entity is sued for its peer review committee's actions that restrict staff privileges.

(4) The physician-patient privilege in section 491.060(5) prohibits the disclosure through discovery of confidential medical information, which the peer review committee documents contain. But by enacting 537.035.5, the legislature determined peer review committee documents are not privileged when a doctor sues a hospital for its committee's actions that restrict staff privileges.

(5) Still, identifying characteristics should be redacted, and the trial court should conduct an in camera inspection of the documents to protect patients from humiliation, embarrassment, or disgrace.

(6) How peer review committees treated other doctors may be relevant in this case, and a discovery request that covers a ten-year period is not per se objectionable. The trial court has not abused its discretion, should continue to monitor the discovery process, and may modify any order upon a showing of "good cause."

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