IN MY OPINION, slapping justifies criminal action. Slapping a child may result in a criminal charge of child abuse. Slapping a spouse may result in a criminal charge of battery. Slapping a senior may result in a criminal charge of elder abuse. However, IN MY OPINION, because they would not face criminal action, the owners of hospitals may decide to SLAPP medical staff leaders.

A SLAPP (Strategic Lawsuit Against Public Participation) provides an interesting legal technique to reduce public criticism by any person or entity with whom you disagree. If someone disagrees with you, sue him! In most cases, just the threat of legal action squelches critics.

The quality of care in a hospital is a major responsibility of the medical staff. IN MY OPINION, if financial mismanagement jeopardizes quality of care in a hospital, the medical staff leaders have an obligation to speak out. IN MY OPINION, if the hospital governing board prevents the approval of medical staff bylaws, then the medical staff leadership must stand up and criticize the governing board actions.

The Joint Commission, Institute for Healthcare Improvement, Leapfrog and NCQA vigorously promote the need for safety and quality in all aspects of medical care. Would they tolerate SLAPPs against their efforts? Such suits fly in the face of their efforts to improve quality of care. Does exposure of an organization's unwillingness or inability to provide quality healthcare warrant a SLAPP? IN MY OPINION, no.

Just imagine if the American Hospital Association sued Leapfrog for exposing unsafe hospital practices and the American Medical Association sued the Joint Commission for advocating for patient safety. Would these "frivolous" suits get past the first judicial review? I seriously doubt it!

And yet suits against medical staff leaders advocating for quality care drag on. Most hospital organization budgets far exceed medical staff budgets. Protracted, financially crippling legal action surely favors the hospital organization. Medical staffs of other hospitals must come to the assistance of any medical staff leader advocating for quality care.

Do SLAPPs work? Yes! Money speaks! For many corporate entities, the financial intimidation to squelch criticism is money well spent. IN MY OPINION, if a hospital corporation participates in intimidation through a SLAPP of medical staff leaders, then it should be held liable for the defendant's legal expenses.

The California Medical Association and the Orange County Medical Association must monitor SLAPP activity against medical staffs and should conduct state and national fundraising to assist any physician confronted with a SLAPP. Without association support, a medical staff leader may feel less safe to advocate for patient care.

The AMA House of Delegates has referred the study of SLAPPs against physicians to the AMA Board of Trustees for a decision. The AMA Organized Medical Staff Section demanded action on SLAPPs after learning of the issue here in Orange County. The issue inflamed the AMA OMSS assembly as it recognized the danger of suppression of medical staff leaders' rights to advocate for quality on behalf of patients.

For the legal details of SLAPPs and greater insight on the process, go to www.thefirstamendment.org/antislappresourcecenter.html. Penalties exist for entities that abuse these legal actions, including paying legal costs, fines and admonitions. If abusive SLAPPs became criminal offenses, these entities would be treated like any abuser.

Martha Stewart went to prison for insider trading. If a corporate entity SLAPPs medical leaders with the intention of preventing criticism of unsafe medical conditions in a hospital, it should be a criminal offense. IN MY OPINION, the danger to the public good in preventing hospital safety disclosure in this kind of case is greater than insider trading. These SLAPP abusers should face criminal charges and incarceration.