Termination of Private Hospital Medical Staff In Texas
The longstanding common law in Texas has been that doctors generally have no cause of action against a private hospital for the denial or termination of staff privileges even where the action was arbitrary and capricious or where rights to due process have been violated. See Tigua Gen. Hosp., Inc. v. Feuerberg, 645 S.W.2d 575, 578 (Tex. App.-El Paso 1982, writ dism'd).
This unfettered ability to make staffing decisions was statutorily limited by the Texas Legislature when it enacted a provision in the Texas Hospital Licensing Law requiring hospitals to afford procedural due process to each person applying for medical staff membership and privileges. See TEX. HEALTH & SAFETY CODE ANN. 241.101 (Vernon 1992 & Supp. 2000).
In addition, the legislature set forth guidelines in the Texas Medical Practice Act for hospitals that choose to adopt rules and regulations relating to qualifications for medical staff appointments. See Act of May 27, 1983, 68th Leg., R.S., ch. 552, 1983 Tex. Gen. Laws 3207, 3209 (repealed) (current version at TEX. OCC. CODE ANN. 151.051 (Vernon Pamph. 2000)).
Under the Act, if a hospital adopts rules for staff appointments, they must be reasonable, without irrelevant considerations, and neither arbitrary nor capricious. Id.
These statutes, although binding on hospitals, do not create a right of action in favor of physicians against hospitals that fail to comply. See Cole v. Huntsville Mem'l Hosp., 920 S.W.2d 364, 372-73 (Tex. App.-Houston [1st Dist.] 1996, writ denied).
Instead, enforcement is statutorily placed in the hands of the State and its agencies.
A hospital's failure to provide procedural due process to physicians applying for privileges may be redressed solely through actions by the attorney general, the Texas Department of Health, or the commissioner of health. See id.; see also TEX. HEALTH & SAFETY CODE ANN. 241.051-.059 (Vernon 1992 & Supp. 2000).
Through the State's actions, a hospital may be enjoined, subjected to civil or administrative penalties, or have its license revoked. Id. 241.051-.059.
A hospital may not, however, be held liable in damages to an individual physician for its failure to provide due process.
Similarly, the Texas Medical Practice Act, which contains the guidelines for medical staffing rules, includes a complex enforcement scheme. See TEX. REV. CIV. STAT. ANN. art. 4495b (repealed) (current version at TEX. OCC. CODE ANN. 165.001-.160 (Vernon Pamph. 2000)).
This scheme does not afford physicians the ability to bring private actions against hospitals. See Cole, 920 S.W.2d at 372-73.
The language of the Act makes the adoption of rules and regulations for medical staff appointments voluntary. See TEX. REV. CIV. STAT. ANN. art. 4495b 1.02 (repealed) (current version at TEX. OCC. CODE ANN. 151.051 (Vernon Pamph. 2000).
Creating a private right of action to enforce the guidelines would discourage hospitals from adopting rules and regulations with respect to staffing and defeat the purpose of the Act, which is to protect the public interest. See TEX. OCC. CODE ANN. 151.003 (Vernon Pamph. 2000).