Judge Rules in Avera Marshall Lawsuit
Date: 27-09-2012
[MMA News Now, Sept. 27, 2012] On Sept. 24, a Lyon County District Court judge ruled that the Avera Marshall medical staff bylaws are not a contract but that the hospital must nevertheless abide by them.
It was Avera administration’s failure to follow the medical staff bylaws that led to the lawsuit filed by Steve Meister, M.D., chief of staff, Jane Willett, D.O., chief of staff-elect, and the organized medical staff this past January. The plaintiffs contended that the hospital was required to follow the medical staff bylaws and that under the then-existing bylaws, the hospital’s board could not unilaterally change them because such action violated the bylaws sections addressing amendments. In the bylaws approved in 2010, both the hospital and the medical staff agreed that any changes to bylaws must include input from the medical staff and must be approved by two-thirds vote of the active medical staff. After study by the medical staff’s executive committee, the majority of the active medical staff rejected the board’s changes.
The physicians objected to the board’s changes in the bylaws because they prevent the medical staff from fulfilling normal duties of medical staff leadership and self-governance, including selecting its own leaders, determining agenda items for medical staff meetings, and calling medical staff meetings. The revised bylaws also give the hospital the unilateral right to impose additional changes in the bylaws, even if such changes are opposed by the medical staff. The physicians also believe that the revised bylaws remove meaningful input by the medical staff in the hospital’s decision making process on matters relating to patient care.
In the ruling, the judge said that although Avera is required to follow the bylaws, it only had to “substantially comply” with the provisions relating to bylaw changes. The judge ruled that even though the revised bylaws were rejected by the majority of the voting members, Avera’s revised bylaws are the valid and current governing bylaws.
“It is well understood in Minnesota that medical staff bylaws are binding on both the hospital and medical staff,” said Robert Meiches, M.D., and MMA CEO. “While the court’s ruling recognizes that bylaws are enforceable, we are disappointed with the ruling overall. Our main concerns in this case have been the role of the medical staff in matters affecting patient care. We got involved because we felt the administration’s changes to the bylaws diminish the medical staff’s role in addressing patient care and in participating in medical staff investigations and peer review proceedings and because they remove self-governance rights.”
The medical staff is currently considering whether to appeal the ruling.
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Comments (2)
Benjamin Whitten
7 months ago
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MD
I think physicians and not corporations have to be the arbiter of issues relating to patient safety and quality of care. It's too bad that Avera didn't seek to partner with their medical staff to set mutually desirable goals and then decide together how to achieve them.
The unilateral ability to change the bylaws is equivalent to the power to nullify them. The decision is an unfortunate one for independent physicians and patients alike and hopefully will not stand up to legal review. I applaud the MMA for participating in this issue and applaud Dr Meister, Dr Willett and their colleagues on the organized medical staff.
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Greg Clark
7 months ago
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MD
Hopefully the Marshall hospital medical staff will fulfull their duties outlined in the bylaws, and not be deficient.
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