Reference no: EM133305176

Assignment: Meyers applied for medical staff privileges at a hospital. Shortly thereafter, the Credentials Committee and the Medical Executive Committee (MEC) and the board of the hospital approved Meyers for appointment to the medical staff. All initial appointments to the medical staff were provisional for 1 year. At the end of that year, the physician was required to be reevaluated for advancement from associate to active staff.

The Credentials Committee began to evaluate Meyers for advancement to active staff privileges. The committee was concerned about Meyers's history: moving from hospital to hospital after disputes with hospital staff, his failure to disclose timely and fully disciplinary and corrective action taken against him in another state, and the quality of his patient care. The MEC voted to accept a Credentials Committee recommendation to revoke Meyers's staff privileges. The MEC was to consider the recommendation from the Credentials Committee and make a recommendation to the board, which had the ultimate authority to grant or deny advancement, or terminate Meyers's privileges.

The board informed Meyers that it was assuming responsibility for determining his reappointment and advancement to active staff because of concerns with the manner in which the peer review process was being handled. Three members of the board, acting as a Credentials Committee, conducted an independent review. This committee discussed concerns about Meyers's behavior and his inability to get along with others, in addition to questions about his surgical technique. The committee questioned Meyers about several incident reports concerning disruptive behavior, his history of problems at other hospitals, his failure to complete medical records timely, his hostility toward the operation room staff, reports of breaking the sterile field, and his failure to provide appropriate coverage for patients while he was away. Meyers acknowledged that he had a personality problem.

The three-member committee of the board voted to deny Meyers's appointment to active staff. The reasons cited for the committee's decision were Meyers's failure to satisfy requirements that he "abide by the ethics of the profession," work cooperatively with others, timely complete medical records, and abide by hospital standards. The committee outlined Meyers's pattern of rude, abusive, and disruptive behavior that included, but was not limited to, temper tantrums, attempted interference with the right of an attending physician to refer a patient to the surgeon of his choice or to transfer the patient, condescending remarks toward women, refusal to speak to a member of his surgical team during surgical procedures, and several instances of throwing a scalpel during surgery. The committee informed Meyers that this behavior could have an adverse effect on the quality of patient care. As for his failure to complete medical records timely, the committee stated "delinquent medical records can put patients at risk by being inaccurate or incomplete if needed to assist in later diagnosis and treatment of a patient."

A Fair Hearing Committee issued its recommendation that Meyers not be reappointed to the hospital's staff because of his failure to meet "ethical standards" and his inability to work cooperatively with others. In May, the board adopted and affirmed the Fair Hearing Committee's recommendation. Ultimately, after further appeals the board revoked Meyers's privileges.

Meyers brought suit in seeking a permanent injunction to require the hospital to reinstate him to staff. The court denied the motion for an injunction that would require the hospital to reinstate Meyers's privileges.

The court agreed with hospital defendants that the behavior of Meyers had the potential of affecting the health and welfare of patients, despite the fact that no patients were actually injured. High-quality patient care demands that doctors possess at least a reasonable ability to work with others. Clearly, the hospital defendants were acting with a reasonable belief that the professional review action was in the furtherance of quality health care. They were concerned that Meyers's behavior would continue until a patient was injured as a result of his actions.22

Question: Ethical and Legal Issues

1. Describe the ethical theories, principles, and values of concern in this case.

2. Describe what steps the organization could take to prevent similar occurrences in the future