Florida High Court Rejects Hospital Governance Law

TALLAHASSEE—The Florida Supreme Court has struck down as unconstitutional a narrowly drawn state statute that allows the board of a private, for-profit hospital operating in St. Lucie County to supercede medical staff bylaws. In Lawnwood Medical Center v. Randall Seeger, MD (as president of the Lawnwood medical staff), the state's highest court agreed with a trial court and an appeals court that the so-called St. Lucie County Hospital Governance Law violated the Florida Constitution because it "granted privilege to a private corporation."

In a 31-page ruling, and with no dissent, the court says the Hospital Governance Law gives the 331-bed Lawnwood "almost absolute power in running the affairs of the hospital, essentially without meaningful regard for the recommendations or actions of the medical staff."

The law applies only to the two private hospitals in St. Lucie County, which is located on Florida's East Coast, about 100 miles north of Miami. Both hospitals are owned by HCA. Nashville-based HCA referred calls to Lawnwood; Lawnwood officials did not immediately return calls seeking comment.

Lawnwood successfully pushed the Hospital Governance Law through the Florida Legislature in 2003 after years of fighting with staff physicians on points ranging from privileging physicians to quality-of-care issues. The issue came to a head in 1999 when Lawnwood removed physicians from its Medical Executive Committee after they declined to recommend disciplinary actions against two staff pathologists that the hospital claimed threatened patient safety.

The Florida Medical Association, which had vigorously lobbied against the law in the legislature, praised the high court's Aug. 28 ruling.

"Physicians who comprise medical staffs are in the best position to make decisions on medical issues that affect patients' well-being, not hospital trustees," says FMA President Steven R. West, MD, a Fort Myers cardiologist.

West called the ruling "an important legal victory" because it will "prevent hospitals from encroaching on medical staff autonomy and becoming embroiled in a legal tug of war over the division of responsibilities within the hospital."

FMA, and the Litigation Center of the American Medical Association, filed friend of the court briefs in both the appellate and supreme courts on behalf of the Lawnwood physicians and helped pay their legal fees.