Division III: Racial Removal of Privileges Interferes with Doctor's Contractual Rights
Here, a doctor was given privileges at a hospital in the Tri-Cities. He is a certified interventional cardiologist. Don’t ask me the specifics of what that means, but I’m assuming it has something to do with the heart, intervening with it, and being certified to do so.
In 2008, his privileges of the hospital were up for renewal. The doctor had been suspended in the past, and a profession was brought in to help determine whether he should continue to be granted privileges of hospital. Side note: most doctors don’t want to be in this position. Because the other three doctors who were being reviewed were being treated differently, and because the doctor was the only one not being paid to provide call coverage, he sued the hospital.
The executive committee of the board of the hospital recommended that the doctor only be partially reinstated; the board rejected this and reinstated the doctor without restrictions. However, they did implement a new requirement regarding the number of procedures a doctor had to have performed in the past two years in order to maintain privileges. Surprise surprise, the standard they selected had only one doctor who did not meet the retroactively applied requirement – Dr. Sambasivan.
The hospital had moved for summary judgment which was granted. The case then went up on appeal and the court decided that there was sufficient evidence to go to trial, reinstating the case:
In reversing dismissal of the [federal and state] retaliation claims we focused, as the trial court had, on whether Dr. Sambasivan had presented evidence from which a reasonable jury could find a causal connection between his discrimination lawsuit and the decision of the Kadlec board to adopt and retroactively apply a proficiency standard that would render him ineligible for renewal of his interventional cardiology privileges. Concluding that he had, we remanded the retaliation claim for trial.
After the case came back, the hospital again moved for summary judgment, this time on the basis that the doctor “cannot identify any contractor employment relationship between himself and Kadlec that gives rise to a retaliation claim under federal or state law and, even if he could, he cannot show any interference with such relationship.” The trial court granted the motion.
The hospital tried to rely on the fact that medical staff bylaws are not a contract and that the hospital had not interfered with the bylaws even if they were. The doctor responded that this was more about the retaliation by the hospital interfering with his own right to form contracts with patience and his contractual right or expectation of on-call coverage. He argues that these are protected by the retaliation provision of Chapter 49.60 RCW.
The Court of Appeals did not revisit the issue of whether the hospital’s decision was motivated by racial animus, which they decided in the previous appeal there was sufficient evidence to go to trial. Regarding what contract was harmed by the hospital’s racial animus, the court pretty much adopted the doctor’s reasoning:
But we would not expect Dr. Sambasivan to address the contractual or noncontractual character of the medical staff bylaws, since the bylaws are not the contract or opportunity that he claims was impaired. He argues instead that he was injured in his contractual rights and relations in two ways: he lost the capacity to contract to perform emergency department call coverage services for the hospital, and he lost the capacity to serve patients who would have come to him at Kadlec for interventional cardiology consultations and procedures. It is only those impaired rights that we need address on appeal.
A case out of the 11th circuit Court of Appeals seemed to hold that if there was no direct contractual relationship, then any ancillary contractual expectations arising out of that relationship were not actionable. This may be my favorite quote of a judicial smack down:
The remaining rationale of Jimenez, simply stated, appears to be this: if a defendant's intentionally discriminatory action against a plaintiff is not itself a breach of contract, then any other contract rights or opportunities that it impairs are not actionable under § 1981. This is wrong under both the plain language of § 1981 and clear precedent.
(Emphasis by yours truly). The court then goes into a litany of United States Supreme Court cases that demonstrate just how long the 11th circuit was in their decision. Their decision to deny him privileges, which arguably had a racial basis was improper. This affected his ability to get on call pay, it affected his ability to work, it affected his ability to see new patients and take new patients.
He is allowed to go to trial and present his claims.