DR. WILLIAM HINNANT, JD
The following is a response by Dr. William Hinnant to an article written by Eric Springer, counsel at Horty, Springer & Mattern, published in the Pittsburgh Post Gazette.
Dear Mr. Springer,
I read with interest your comments regarding Steve Twedt's Post Gazette series published recently. Personally, I have respected you and your firm for some time and have found your website to be a good repository for health related legal information.
As a physician and attorney with experience in medical staff issues, I wanted to comment about your editorial. I, for one, would not consider most physicians involved in medical staff leadership to be "leaders". Typically they have far less support from the medical staff than the hospital administration and do not represent mainstream practitioners. The same typically applies to those serving on state medical boards. Medical staff officers typically gain those positions by being "yes" men to the administration as opposed to representing the interests of physicians.
Secondly, physicians labeled as disruptive typically are just that--"disruptive". This label was meant to be attached to those potentially guilty of sexual harassment, workplace discrimination and/or assault and battery on hospital employees and/or their colleagues. I have found in more cases than not, said label simply is a mechanism to punitively discipline those vocally opposed to policies propounded by the administration. It is also rather amazing that those labeled disruptive or subjected to arguably-unfair peer review are typically 1) solo practitioners as opposed to group members; 2) physicians utilizing more cutting edge technology or more aggressive that the average; 3) never members of the Medical Executive Committee, Board or visible hospital committees; 4) typically not socially interested in being a part of the hospital's "in" crowd, the latter usually benefiting through some kickback from the hospital excepted by the Anti-kickback statute and/or Stark II.
The disruptive physician is seldom the beneficiary of a hospital contract. I have begun to subpoena the IRS form 990 of all hospitals I oppose and also copies of their form 1023's to get a handle on exactly what wording is used in their charitable purpose descriptions. I usually can uncover violations of the IRS private inuring and benefit doctrines. As you are well aware, hospitals pay exorbitant legal fees to undercut and find every possible exception to avoid allegations of fraud and abuse and/or any challenge to their 501(c)(3) status.
In short, hospitals and their so-called medical staff "leaders" are a social clique, a country club, a small group which indirectly benefit from the hospital's ability to disguise such benefits under the personal service exception. I do believe that the majority of physicians disciplined are victims, unable to fight back effectively against the 800 lb gorilla hospital with unlimited funds, well compensated counsel and a public opinion easily swayed by anything disguised under the garb of "patient protection". HCQIA was and is faulty legislation, albeit passed with a good public policy consideration. The immunity is simply too broad and the burden of proof misplaced. The broadness of the language allowing imposition of attorneys fees on the non-prevailing party is unreasonable as is that of the provisions required to achieve immunity. While I realize that it has benefited the majority of your clients, it is bad for physicians and bad for the public at large.
Thanks for your time in reading my comments. I continue to respect and admire your firm as a national leader in health law. Best wishes.
Bill Hinnant
C. William Hinnant Jr. MD JD DABU FCLM
Attorney at Law
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