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Dimitry K., Esq.
Dimitry K., Esq., Attorney
Category: Business Law
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Experience:  Run my own successful business/contract law practice.
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I am a surgeon and am having a hassle with my local branch

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I am a surgeon and am having a hassle with my local branch of the University HOspital. I have privileges there for 28 years but gave up my block (reserved) time a few years ago. I am now needing to go back there, largely because of insurance issues.

When I requested block time, I was told none was available, and when we tried to book non block time we were told thre is no time available through the end of 2011.

My question is whether I have a right to be able to book cases and to have block time if others also have it, or do they have absolute and arbitrary discretion about whom they grant block time and how much. I told them that they either have to open extra hours or take block time from someone else, but they are not budging. I also brought up the problem of not being able to book non-block time, being told there isn't any.

I am wondering if I have a right to this time, and if there is any governmental or third party agency that adjudicates these matters.
Submitted: 2 years ago.
Category: Business Law
Expert:  Dimitry K., Esq. replied 2 years ago.
Thank you for your question.

Ultimately the hospital is a private entity. They are free to grant or withhold time if they so deem, provided the withholding is not discriminatory. Therefore regardless of whether or not you had a prior block time agreement with the hospital, you no longer maintain such a relationship at this time. Therefore they are very much free to not allow you the time as they do have arbitrary discretion. Therefore if you book cases, the hospital does not have to honor it, and does not have to allow you to treat your patients at the hospital. While you can request they take time from someone else, if that someone else has an existing agreement with them, his right to the use of the premises outweighs yours, as you currently do not have a contract in place.

This, ultimately, is a contractual issue, not a governmental issue. The only legitimate recourse is the courts since not even medical boards would get involved in this sort of a private disagreement.

Good luck.
Customer: replied 2 years ago.

This is a non-profit entity, not private, in the usual sense, and amongst the largest health care system in the US.

 

They are also effectively a monopoly and remember that I do have privileges. While I understand that they do not have to grant privileges, when they do grant them, are they not obligated to let me use the facility that they have given me privleges at/ Isn't that what the word "privileges" means? If not, then what value, or meaning does that have?

 

While I am not trying to argue t he point, the question is: who has the right to grant the blocks of time, or allow or not allow cases to be booked.

 

I would mention that I recently received re-appointment, and that thye are now requiring that we perform at least 10 surgical cases a year in order to maintain re-credentialing. They can't, I would think, preclude me from doing what is requried in order to maintain the qualifications that they themselves set as standards, can they?

Expert:  Dimitry K., Esq. replied 2 years ago.
Thank you for your follow-up, and your extremely detailed and thought-out reply. I will do my best to respond in kind.

This is a non-profit entity, not private, in the usual sense, and amongst the largest health care system in the US.

Even so, they are run by the Board. The Board delegates responsibilities and rights to officers, who make a determination as to how to best run this non-profit. Those who run it can still do so with discretion within their position.

 

They are also effectively a monopoly and remember that I do have privileges. While I understand that they do not have to grant privileges, when they do grant them, are they not obligated to let me use the facility that they have given me privileges at/ Isn't that what the word "privileges" means? If not, then what value, or meaning does that have?

I am unclear as to what "privileges" you may have when you stated that you are no longer affiliated with the hospital. If you can explain, I may be able to revise my analysis, but so far I still see no duty on their part to provide you with access.

 

While I am not trying to argue t he point, the question is: who has the right to grant the blocks of time, or allow or not allow cases to be booked.

They do, as that is wholly within their discretion.

 

I would mention that I recently received re-appointment, and that they are now requiring that we perform at least 10 surgical cases a year in order to maintain re-credentialing. They can't, I would think, preclude me from doing what is required in order to maintain the qualifications that they themselves set as standards, can they?

Most likely no, they cannot preclude you, provided that you perform all conditions under which re-appointment must be pursued. By that I mean if they require fees, applications, certain proofs, you are required to comply and then if you are part of their network, they can permit you to perform the duties that allow you to be re-credentialed. As for scheduling, that is still up them--they still owe you no duty in granting time as your re-credentialing is not their obligation.

 

Good luck.

Customer: replied 2 years ago.

Ok, I guess I was not making myself clear. I had given up my block time a few years ago and started working elsewhere, but I have always had an appointment as a member of the staff. Yes, I AM a member of the staff, that is, I have admitting privileges, pay dues etc. While I understand they are not obligated to grant such privileges (ie. staff appointment or affiliation), once having done so, the question is whether they are then obligated to give equal access to all members so designated. Keep in mind that I now rank as a SENIOR member of the staff after 28 years (plus three years of residency, to boot).

So, please reframe your answers in light of the fact that I do have staff appointment, and to whom I should turn regarding getting patients actually admitted for surgery.

thanks!

Expert:  Dimitry K., Esq. replied 2 years ago.
Thank you for your follow-up.

That is actually much clearer as I read that upon leaving the network, you lost your privileges. Being a nominal member of the staff does make a difference--while the hospital still has discretion in how they fill in your hours, you can demand that as an affiliated member they do provide some reasonable accommodations for you and for your patients. As for whom to speak with, that is a tough situation. I would start with HR and possibly the legal affairs section (claiming that you may be a victim of favoritism and discrimination), and ultimately you would need to speak with the head of the department who conducts scheduling. If that fails, try to contact the Board directly for a formal response.

Good luck.
Dimitry K., Esq., Attorney
Category: Business Law
Satisfied Customers: 37089
Experience: Run my own successful business/contract law practice.
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