Are medical staff bylaws considered hospital contracts?

A Minnesota district court ruled medical staff bylaws are not a contract between hospitals and physicians, challenging the traditional role that bylaws serve between management and clinicians, American Medical News reported.

When physicians on the medical staff of Avera Marshall (Minn.) Regional Medical Center sued the hospital in January for abandoning its bylaws in favor of new ones, the physicians claimed the hospital didn't follow its own rules to make amendments, thus breaching their "contract."

Avera Marshall Regional argued the bylaws are not a contract, and therefore the medical staff doesn't have the right to sue. It further asserted that the medical staff is part of the hospital, and the hospital can make decisions in the best interest of the institution, amednews noted.

Medical staff bylaws have traditionally been an instrument of self-government that set the ground rules for quality, including credentialing and peer review, guidelines for behavior, disclosure of conflicts of interest and due-process rights. In addition, bylaws most often include a clause on how to amend language in them to ensure a democratic form of hospital-medical staff relations.

The court last month said the bylaws do not include the necessary legal requirements to make the regulations a binding contract. However, it also noted that Avera must follow the former bylaws, including the proper process to amend any rules.

The state ruling could have repercussions for the rest of the country, setting a bad precedent, according Robert Meiches, CEO of the Minnesota Medical Association. "A hospital's medical staff serves a critical role in facilitating and maintaining quality patient care in a hospital setting and needs to have a strong voice in the governance process regarding patient care," Meiches told amednews. The ruling diminishes "the role of the physician in making patient care decisions, in conducting medical staff investigations and peer review proceedings and performing regular duties," he said.

For more information:
- read the amednews article

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