The Legal Status of Medical Staff Committees
A hospital medical staff is an unusual entity. It serves the interests of the hospital but is not part of the hospital corporation. Because most states place limits on the ability of physicians to work for hospitals directly, the hospital usually does not employ or control the actions of the members of the committee. The medical staff is legally separate from the constituent physicians’ practices. They may engage in joint decision making for the hospital, but they are not a joint venture with the hospital. It is important to note that the courts have found that the members of a hospital medical staff are, by definition, a conspiracy.
This view was articulated in Weiss v. York Hospital, [ Weiss v. York Hosp., 745 F.2d 786 (3d. Cir. 1984).] an antitrust case. The plaintiff in Weiss had sued some of the individual physicians on the medical staff, but he had also sued the medical staff itself as an independent entity. The court found that the medical staff had no independent legal existence but accepted the plaintiff’s allegation that the individual physicians were engaged in a conspiracy as defined in section 1 of the Sherman Antitrust Act:
We agree with the Plaintiffs that, as a matter of law, the medical staff is a combination of individual doctors and therefore that any action taken by the medical staff satisfies the “contract, combination, or conspiracy” requirement of section 1. [Weiss at 815.]
The key to this case is the distinction between the medical staff as an entity unto itself and the individual physicians who make up the medical staff. Although the trial court instructed the jury that the medical staff was an “unincorporated division” of the hospital and thus the two were a “single entity,” incapable of conspiring, it was careful to distinguish the actions of the individual members of the medical staff:
The Court also instructed the jury, however, that if they found that some or all of the individual Defendants took action against the Plaintiffs “in whole or in part in their individual capacities and motivated in whole or in part by independent personal economic interests, then such individual- named Defendants are, under the law, independent economic entities … legally capable of conspiring with York Hospital or its Medical and Dental Staff.” [ Weiss at 813.]
In the case of Quinn v. Kent General Hospital, [ Quinn v. Kent Gen’l Hosp., 716 F. Supp. 1226 (1985).] the court expanded on this distinction between the medical staff and the individual physicians:
It is certainly true that, regardless of their specialty, the members of the Hospital’s active medical staff have a financial interest in limiting the number of physicians admitted to active staff privileges at the Hospital, for all admitting staff members compete with each other.… The active staff cannot be regarded as a single economic unit, but must be viewed as a collection of independent economic actors who are capable of combining or conspiring with each other for purposes of the Sherman Act. [Quinn at 1242.]
The holdings of the Weiss and Quinn courts represent the view that medical staff committees satisfy the legal definition of a conspiracy: an informal relationship between independent parties to carry out joint action. Conspiracy is generally used as a pejorative term, but here it is presumed that the conspiracy is for good, not evil. Nonetheless, it means that medical staff committees that act improperly are subject to the same federal laws that govern traditional illegal conspiracies, including the antitrust laws and the Racketeering Influenced Corrupt Organizations Act (RICO).