Through SB 1325, the California Medical Association fought and won the right for a medical staff to have a legal identity. SB 1325 enshrined in law the principles of medical staff self-governance. SB 1325 was one of Steve Thompson's final accomplishments in the California Legislature. The governor signed SB 1325 (one of the few bills he signed in 2004), claiming it would protect the quality of medical care in California. And yet do we have the will to stand up and fight for the principles of SB 1325?

I'm not sure.

And I'm angry and frustrated about it.

Medical staffs at Western Medical Center Santa Ana (WMCSA) and Chapman Medical Center (CMC) are exerting their self-governance rights. In 2004, Integrated Healthcare Holdings Inc., a newly formed corporation, purchased these hospitals from Tenet Healthcare Corp. The medical staffs at these hospitals have struggled with the transition. One of the main issues is the ability of the medical staffs to be self-governing and to influence quality of care. Each medical staff drafted new medical staff bylaws. Neither set of bylaws has received approval. Is this self-governance?

The struggle resulted in IHHI suing the past chief of the medical staff at WMCSA, Michael Fitzgibbons, MD. The WMCSA medical staff established a legal defense fund to assist Dr. Fitzgibbons. It appears that members of the WMCSA medical staff have interpreted the suit against Dr. Fitzgibbons as a suit against the medical staff as a whole. The medical staff at CMC made a contribution to this defense fund.

I think it's extremely important that we in Orange County and in California support these medical staffs in their fight to remain self-governing. I would like all medical staffs to send a contribution to help in the effort.

Perhaps I'm so passionate about the self-governance issue because I was there in the beginning. I first attended the CMA House of Delegates when Dolores Hope (yes, Bob's wife) decided that David Stotzman, MD, a (lowly) family practitioner should not represent the medical staff on the board of directors at Eisenhower Medical Center. Although elected chief of staff by the medical staff with a strong majority and reaffirmed on a second vote, the board refused to recognize his election. The CMA HOD firmly supported Dr. Stotzman and the right for a medical staff to choose its own chief.

Ultimately, Goliath (Eisenhower Medical Center) relented and allowed David to take his place on the board.

Then, in March 2003 at the CMA HOD, this ugly issue arose again. The medical staff of Ventura-based Community Hospital of Buenaventura was challenged. The CEO assumed he could control the medical staff. When "they" (the medical staff) refused to follow his guidance and agree to his vision of the hospital, he simply asked the board of directors to remove the elected medical staff leaders and replace them with his appointees! The medical staff refused to take it and reinstated its elected leaders. This led to the infamous lawsuit of the Community Hospital of Buenaventura board vs. the Community Hospital of Buenaventura medical staff.

The board claimed the medical staff had no legal standing! So the CMA HOD picked up the issue and eventually won passage of SB 1325.

The final outcome in Ventura was good. It included the ouster of the CEO, a new set of medical staff bylaws, and a revived relationship between a new board of directors and an elected medical staff.
But now in Orange County, two medical staffs are struggling to assert their rights to self-governance. The WMSCA and CMC boards of directors have refused to ratify the medical staff bylaws approved by the medical staffs.

Will the CMA and the Orange County Medical Association have the fortitude to stand with these valiant medical staffs in their quest to be the first to assert the rights won by the passage of SB 1325? Will the threat of lawsuits frighten them from speaking out and supporting these medical staffs? Will the CMA HOD force the CMA to act? The CMA HOD does not meet until October 2006. Can these medical staffs hold out? If not, SB 1325 will be a hollow victory!