Kessel v. Monongalia County General Hospital Co., 215 W. Va. 609

Summary

The Supreme Court of Appeals of West Virginia answered a certified question concerning whether a public or quasi-public hospital may enter into an exclusive medical-services contract that completely excludes physicians with staff privileges from using the hospital’s facilities. The court held that medical staff bylaws generally do not constitute a contract, and that quasi-public hospitals have the same duty as public hospitals to admit qualified physicians and avoid unreasonable, arbitrary, capricious, or discriminatory exclusions. It further held that such hospitals may not use exclusive contracts to completely exclude staff physicians from practicing in the hospital.

Holdings

1. Absent consideration beyond the parties' preexisting statutory duties, a hospital's medical staff bylaws do not constitute a contract between the hospital and its staff physicians.
2. Absent express language to the contrary, medical staff bylaws do not apply to hospital management decisions that affect physicians for business or administrative reasons rather than allegations of professional incompetence or misconduct; when incompetence or misconduct is alleged, the hospital is bound by the bylaws' fair-hearing provisions.
3. The plaintiffs did not establish a constitutionally protected property interest in continued staff privileges at the hospital.
4. A quasi-public hospital has the same duty as a public hospital to admit regularly licensed physicians to its medical staff and is subject to the same judicial review of rules, regulations, or acts that deprive staff physicians of the ability to practice in its facilities.
5. A public or quasi-public hospital may not enter into an exclusive contract with a medical service provider that completely excludes other physicians who hold staff privileges from using the hospital's medical facilities.

Questions Presented

1. Whether a public or quasi-public hospital may enter an exclusive medical-services contract that completely excludes physicians with staff privileges from using the hospital's facilities.
2. Whether the hospital's medical staff bylaws constituted an enforceable contract between the hospital and its staff physicians.
3. Whether the hospital's medical staff bylaws governed the relationship and required fair-hearing procedures for a non-disciplinary management decision.
4. Whether the plaintiffs had a constitutionally protected property interest in their hospital staff privileges.
5. Whether Monongalia General Hospital was public or quasi-public for purposes of the physicians' right to practice and the scope of judicial review.

Disposition

other