Holland & Hart Healthcare Law Blog

California Nixes Medical Discrimination By Religous Doctors.

The California Supreme Court has ruled that physicians may not discriminate and withhold  non-emergency medical care based upon their religious beliefs in violation of the California Unruh Civil Rights Act, which prohibits discrimination by businesses based on sexual orientation.  In North Coast Women's Care Medical Group, Inc. et al. v. San Diego Superior Court, a lesbian, Guadalupe T. Benitez brought suit against the physician group and two individual doctors for refusing to provide intrauterine insemination using unfrozen semen from a friend to assist her obtaining pregnancy. This is a medical procedure in which a physician threads a catheter through a patient's cervix and inserts semen through the catheter into the patient's cervix. One of the physicians claims that her religious belief's in question have more to do with the patient being unmarried than a lesbian, but that is disputed by the plaintiff.

Supreme Court Holds Arbitration Agreement Under F.A.A.Cannot Be Reviewed For Erroneous Conclusion of Law

There is a growing tendency to incorporate mandatory arbitration clauses in employment and other agreements as an alternative mechanism to resolve disputes. Some arbitration agreements go so far as to self define the scope of judicial review of an arbitrator’s decision. Not infrequently, there is a tension in a case between the equities or basic fairness and the law. An arbitrator, after all, is supposed to be arbitrary. He or she is supposed to quickly and economically cut through the "Gordian knot" of a dispute and do what is right.

PHYSICIAN COMMUNITY NEEDS ASSESSMENTS:“LIES, DAMN LIES AND STATISTICS?” Part II of II

Recently, a national chain hospital located in a highly competitive market in Los Angeles, California used a home office prepared CNA developed in another state to attract an invasive cardiologist to move to L.A. and start up a practice. The corporate recruiter announced that he had given the physician a copy of the CNA to "hammer home" the need. Neither the CEO of the hospital or even the recruiter had much of an understanding of the methodology utilized in the development of the CNA. They knew only that they could look through the two-inch thick document to two particular pages where corporate had concluded that in 2007, based on 2003 data there would be an objective need for 7 to 8 additional cardiologists in the hospital’s GSA. This conclusion was based solely on statistical data and benchmarks from a number of different sources and virtually no anecdotal or qualitative survey confirmation in the market whatsoever.

Physician Community Needs Assessments:“Lies, Damn Lies and Statistics?”Part I of II.

The line between a hospital’s medical staff competitive development activities and its community medical support endeavors is hazy, but one that has important regulatory and legal implications. The luring of certain physician specialists to a hospital’s market is often a key component in the competitive strategic plan of the hospital, yet the offering of "anything of value" to induce physician referrals is illegal under Federal law, without the demonstration of an independent "community need" for the physician. Alan Coleman, Vice President for Business Development at Tri City Medical Center in Oceanside California underscored the necessity of recruiting specialists that have an effect on a hospital’s bottom line.

We went and looked at the number of neurosurgery cases that are occurring in our market and what percentage of the market we were capturing here at Tri-City, and it was dramatically lower than all of the other surgeries.

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We have to have profitable service lines to cover unprofitable service lines like pediatrics and mental health.

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We go after those just to keep the doors open for all services.

Sisson, Paul "Local Hospitals Turn To Cash Incentives To Lure Doctors," North Country Times (August 14, 2004).

International Patient Dumping by Hospitals Scored in New York Times

On Aug. 3, 2008, the New York Times ran a front page feature story chronicling the apparently widespread practice by U.S. hospitals in dumping illegal (and sometimes legal) immigrants abroad in order to avoid the high cost of treatment and maintenance in the United States.  The feature, “Deported by U.S. Hospitals,” written by Deborah Sontag, largely follows the medical and legal passage of one Luis Alberto Jiménez, a Guatemalan illegal, who was working as a gardener in Stuart, Florida when he was struck by a drunken Floridian, suffering severe traumatic brain injury.