Richard Bolt, M.D., was filled with frustration, disbelief and anger as he explained what ended his career as a vascular surgeon.
For 12 years, Dr. Bolt has been fighting the Daytona Beach, Fla., medical community in court over what he said was a conspiracy to run him out of town and destroy his medical practice.
He said his crime was challenging the city's medical hierarchy, including Alvin Smith, M.D., who is now president-elect of the Florida Medical Association.
"I can't see how someone's career can be ended like this," Dr. Bolt said during an interview in his home on Amelia Island, Fla.
Physicians and hospital executives in Daytona Beach countered that Dr. Bolt was hostile to other health professionals and recommended that he seek psychiatric counseling. After a two-year probation, they voted not to reappoint Dr. Bolt to the staff of three area hospitals.
The 12-year-old dispute between Dr. Bolt and the Daytona Beach medical community will return to federal court this week, when the physician's antitrust lawsuit is heard again.
A decade ago, in February 1984, U.S. District Judge Richard Kellum ruled in favor of the three hospitals and five physicians Dr. Bolt had sued. The judge ruled that Dr. Bolt had failed to demonstrate that the hospitals and physicians conspired to kick him off the hospitals' staffs.
But the 11th Circuit Court of Appeals in Atlanta overturned Judge Kellum's ruling and sent the case back to the U.S. District Court in Orlando, Fla., for a new trial.
The appeals court ruled that Dr. Bolt was not allowed to call his expert witness, Edward Woodward, M.D., chairman of the surgery department at the University of Florida Medical School, to testify about his review of several medical cases. Those cases were used by all three hospitals to revoke Dr. Bolt's privileges.
Dr. Bolt moved to Daytona Beach in the fall of 1979, and was granted probationary staff privileges at Daytona Community Hospital and Halifax Hospital Medical Center, both in Daytona Beach, and Memorial Hospital-Ormond Beach (Fla.).
Two years later, on Sept. 10, 1981, Daytona Community Hospital's credentials committee met to discuss Dr. Bolt's reappointment. The panel noted it had received complaints about Dr. Bolt's "hostile, disruptive and antagonistic behavior from the (hospital's) nursing staff, patients, physicians and administration."
The credentials committee voted to recommend Dr. Bolt's reappointment on the condition that he seek psychiatric counseling through the Impaired Physicians Program of the Florida Medical Association. The FMA program, based in Fernandina Beach, Fla., provides help for physicians suffering from mental illness or drug or alcohol abuse.
When Dr. Bolt would not agree to that, the hospital decided on Sept. 22, 1981, not to reappoint him to its staff. Dr. Bolt said he did not need treatment for mental illness or chemical abuse.
"What's the most damaging thing you can call someone?" Dr. Bolt asks. "Crazy." Claims of mental illness can devastate a physician's reputation, he said.
He sued the hospitals in March 1982, alleging violations of federal antitrust, contract and constitutional law.
In siding with Dr. Bolt, the federal appeals court wrote: "A fact-finder could infer from this evidence, in addition to the evidence admitted at trial, that the (hospitals) relied on the same baseless conclusions as part of a scheme to achieve a common illicit end."
Named as defendants in the case were Halifax Hospital Medical Center, Daytona Community Hospital and Memorial Hospital-Ormand Beach, and five physicians: Alvin Smith, Richard Boye, Ralph Marina, Shedrick Roberson and Willis Stose. Dr. Stose has settled, and Halifax was dropped as a defendant because of its state immunity. Daytona Community Hospital is now Daytona Medical Center after it was purchased by Columbia/HCA Healthcare Corp.
"There was a handful of doctors out to get me," Dr. Bolt said.
Although he still has a medical license, Dr. Bolt no longer practices medicine.
"This is really a guy who has been chewed up and spit out by the system," said Hal K. Litchford, an Orlando attorney representing Dr. Bolt.
Clinton R. Batterton, a Washington attorney representing Drs. Smith and Roberson, said he expects the case to go to trial because mediation efforts have failed.
"Dr. Roberson and Dr. Smith are guilty of nothing more than doing their jobs," said Mr. Batterton, explaining that his clients had to make sure only qualified physicians were practicing at the hospitals.
Dr. Bolt said his troubles in Daytona Beach began in October 1979, when he was told during a dinner meeting with Dr. Smith that it would be unwise to become involved with Florida Health Care, an HMO.
Dr. Bolt said he agreed to perform surgery on the HMO's patients, angering Dr. Smith and the local medical establishment.
Dr. Bolt said the physicians and hospitals retaliated by alleging that his care of several patients was inadequate.
"They first wanted to review all my charts," Dr. Bolt said. "They found I was competent."
Mr. Batterton countered that Dr. Bolt was out of control.
"He was getting people so upset and rattled that they couldn't do their jobs," Mr. Batterton said.