4/2/2013 5:00:00 PM GUEST OPINION: Medical staff attorney responds to allegations
By Dean J. Smith Taylor Blessey, LLP
It seems that nearly everyone in Blythe has an opinion about Palo Verde Hospital. Under the circumstances that is certainly understandable. But there are a few misconceptions that seem to be driving much of the controversy which has surrounded the Hospital for more than a decade.
First of all, despite what has been reported in this newspaper, the doctors are not the bad guys. The bad guys are the ones attacking the doctors with a well orchestrated smear campaign which seeks to "take back the hospital," as though the doctors are "holding it hostage." The problem with that argument is that without the doctors there is no hospital.
There are some in town who wonder why the Board doesn't just "get rid of" the doctors (or at least one in particular). Well, it just doesn't work that way. Doctors are not employees of the hospital. They cannot be "fired." The reason for that is a matter of public policy. The State of California decided long ago that it is in the best interest of patients that their doctors' medical judgments are not subject to second guessing by people "supervising" them who have never gone to medical school and who have never completed a residency.
Doctors practice at a hospital, not because they are employees, but because they have been granted "staff privileges" after going through a process called "credentialing" or "peer review." Prior to being granted staff privileges a doctor is required to submit an application and his or her credentials must then be reviewed by other doctors (his or her "peers") who will then make a recommendation to the governing Board of the Hospital to either grant or refuse to grant the doctor the staff privileges he has requested.
California law actually requires that all "peer review" of doctors be done by doctors, and only by doctors. That includes the process required for assessing initial membership applications, the process for assessing applications for reappointment and any disciplinary investigations and actions which may come up from time to time. California law also provides that the only entity in a hospital which is legally authorized to conduct this peer review is the hospital's medical staff; not the governing Board and not the CEO.
That is not something the Medical Staff at Palo Verde Hospital just made up. It is the law in California and in every other state in the United States.
After reviewing an applicant's credentials, if the Medical Staff recommends that he or she should be appointed, or that an existing member should be reappointed, for the most part, the governing Board is simply not obliged as a matter of law to second guess that recommendation. It generally must accept it. And that is what usually happens. If the Medical Staff gives an adverse recommendation to an applicant physician, he or she is entitled to a hearing by a panel of physicians called a "Judicial Review Committee" or "JRC." The decision of the JRC is then only appealable under very limited circumstances. And again, for the most part, the Board is simply not obliged to second guess the decision of the JRC. And they usually don't.
In fact, in every other hospital in America, that is how it works. When the Medical Staff makes a recommendation, the governing Board follows it. Most of the time, that is how it has worked here in Blythe; but not always.
It has been reported in this newspaper that last year the old Palo Verde Healthcare District Board disregarded the recommendation of the Medical Staff and made the decision to renew Dr. Sahlolbei's privileges for only three months, rather than the standard renewal of two years as is called for by the Medical Staff Bylaws and the regulations of Joint Commission of the Accreditation of Healthcare Organizations. That decision by the Board was improper and when Dr. Sahlolbei appealed, a JRC composed of three well qualified outside physicians agreed that it was improper and they recommended that Dr. Sahlolbei should be given a full two year reappointment. The new Board recently agreed and approved Dr. Sahlolbei's reappointment for a full two year term.
That should really be the end of the discussion, because California law also makes physician peer review strictly confidential. That means no matter how much the public might wish to have an explanation of the reasons for a particular recommendation by the Medical Staff they are simply not permitted to know. Again, that is not something unique to Blythe. That is the way it is throughout California and every other state.
Secondly, there are those who have criticized the Medical Staff for being "greedy" and "litigious." Yet, bear in mind that while the Medical Staff has filed three lawsuits against the Hospital and its governing Boards in the past 10 to 12 years, they have never sought money damages and in each case the Medical Staff won. In each case, a Superior Court judge issued an injunction against the governing Boards of the Hospital who they sued. I cannot over emphasis how rare that is. The Medical Staff has prevailed each and every time they have gone to court.
So, ask yourself this question. If the Medical Staff is the "problem," why does it keep winning? If the Medical Staff is the problem, why has three different well respected Superior Court Judges issued injunctions against the governing Board? The truth is that this situation is so unusual that I am not aware of any other Hospital anywhere in the United States where the medical staff has successfully sued its governing Board even once in ten years; let alone three times.
Last November there was an election that changed the makeup of the Palo Verde Healthcare District Board. Elections are supposed to have consequences. They are supposed to reflect the will of the people. Yet, for apparently purely political reasons, the outgoing Board tried to thwart the will of the electorate by illegally trying to tie the hands of the incoming Board members in order to orchestrate their eventual failure, probably to begin jockeying for the next election.
First, they tried to lock the new Board out completely by illegally attempting to delegate essentially all of the Board's power to the former CEO. When the Medical Staff intervened and the courts prevented them from doing that, they tried to tie the hands of the new Board by claiming multiple conflicts of interest. At the same time, the old Board's legal counsel continued to pursue the old Board's political agenda by pursing litigation against Dr. Sahlolbei. Fortunately, all of those political "dirty tricks" have now been undone.
As the Medical Staff's attorney, I have read the recently dismissed complaint which was filed by the prior Board against Dr. Sahlolbei. I can tell you that based on what I read I am not surprised that Dr. Sahlolbei's demurrer was sustained. The new Board made the right decision when it voted to dismiss that case. In my opinion, the case was meritless. It was just another in a long line of "scorched earth" plans to try to get rid of Dr. Sahlolbei, who often says things that need to be said, even though some people do not want to listen.
It is time for everyone in this Blythe melodrama to put politics aside. It is now time for rebuilding. There is now a new Board and a new Administration and they both need to work with the Medical Staff for the good of the hospital and the people of Blythe. When that has happened in the past the hospital has prospered. It needs to happen again.