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American Academy of Emergency Medicine

Court Upholds Hospital Credentialing Requirements

Source: CMA ALERT No. 1792 February 16, 2001

The Ninth Circuit Court of Appeals ruled last month that hospitals and medical staffs do not necessarily violate antitrust laws by jointly adopting criteria that may restrict physicians' medical staff privileges on the basis of board certification.

In County of Tuolomne v. Sonora Community Hospital, a family physician filed an antitrust suit against the hospital and its medical staff over its policy that only board-certified or board-eligible obstetricians, or physicians who completed a 36-month residency program in OB/GYN, could perform C-sections at the hospital. The effect of the credentialing requirement, the physician alleged, was to harm his business by restraining his ability to perform C-sections.

The court dismissed the physician's claim, citing a lack of either direct or circumstantial evidence of a conspiracy against him, and a failure to convince the court that there was a better way to make sure physicians are sufficiently trained to perform any given procedure. The court concluded that "any anticompetitive harm [of the credentialing requirement] is offset by the procompetitive effects of [the hospital's] efforts to maintain the quality of patient care that it provides."