California Society of Anesthesiologists Bulletin 62-4 - (Page 36)

LEGALLY SPEAKING Process and Outcome: Lessons from Fountain Valley By Phillip J. Goldberg, Esq, CSA Legal Counsel O n May 30, 2013, approval, of medical staffs when changes were made in the Orange County hospital-based physician contracts. Because the CMA's bill Superior Court denied a did not become law, anesthesiologists should recognize that motion for a preliminary hospital administrators have extremely broad discretion injunction by the medical in selecting the group to staff the hospital's anesthesia staff at Fountain Valley department. This does not mean anesthesiologists have Hospital to stop the no control over their positions at the hospital, but they do hospital from replacing need to adapt their tactics to the legal environment. Since the incumbent anesthesia anesthesiologists have limited legal bases for challenging group. The basis of the decisions on anesthesia contracts, anesthesiologists should claim was that the hospital failed to comply with a medical adopt a strategy of reducing hospital administrations' staff bylaws provision requiring meaningful consultation inclination to replace one anesthesia group with another. between hospital administration and the Medical Executive Although competition is increasing with more and more Committee (MEC) before making changes in the contract. national anesthesia companies coming into the California The lawsuit involved an issue of process and not outcome, market, there are strategies incumbent groups can and and this provides a lesson to anesthesiologists. should use to protect their positions. The bylaw in question required meaningful consultation Prevention: An Excellent Working Relationship between the MEC and the hospital, but it did not require the hospital to follow the advice of the MEC. In my experience, bylaws provisions such as this - where at least a process is supposed to be followed before a hospital makes a decision on contract changes - are relatively rare. A bylaws provision that gives the MEC effective control and veto power over a hospital's decision with respect to contracts is virtually unheard of. Several years ago, the California Medical Association sponsored legislation that would have required not only the input, but also the Rather than threatening a lawsuit, anesthesiologists are better served by influencing the primary decision-makers with the power to replace the anesthesia group, and also by securing as allies others who have the opportunity to influence these decision-makers. I recommend that anesthesiologists make themselves partners with the hospital administration and develop the very best possible working relationship with the non-physician hospital staff, as well as the other members of the medical staff. The medical maxim that an ounce of prevention is worth a pound of cure applies 36 to anesthesia contracts. | CSA Bulletin 

Table of Contents for the Digital Edition of California Society of Anesthesiologists Bulletin 62-4

Airliner Crashes and Patient Handoffs — Is There a Connection?
It Is a New Day
LPAD Gears Up for a New Year
Full House? Playing Political Poker ‘Under the Dome’
CSA FALL SEMINAR 2013: ANOTHER HAWAIIAN SUCCESS
The ASA Annual Meeting
UPCOMING CSA ANESTHESIA SEMINARS
Is ‘HAL’ Coming to a GI Suite Near You?
Bookending Propofol — A Technique to Avoid PONV
Process and Outcome: Lessons from Fountain Valley
An Educational Gift from the Internet
A Major Challenge to Your Practice from Sacramento
Propofol Dreams: Of Nightmares and Déjà Vu?
NEW MEMBERS
CALIFORNIA AND NATIONAL NEWS
Fall 2013

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