The California Medical Association is deciding whether to fight a state appellate court decision that could significantly affect how medicine is practiced in public healthcare facilities.
CMA attorney Astrid Meghrigian said the association may appeal to the California Supreme Court a three-judge state appellate panel's unanimous ruling to allow the University of California at Los Angeles to continue barring anesthesiologists who aren't members of the university's faculty from practicing at a satellite facility, 221-bed Santa Monica-UCLA Medical Center.
The appellate court held that UCLA's status as a public institution exempts it from traditional corporate practice of medicine guidelines.
"We're keeping our options open," Meghrigian said. She added that the ruling is "so wrong that it's energized us even more" to continue the fight.
But University of California attorney Ethan Schulman disagreed. "The opinion is obviously correct, and it's hard to see any issue of importance that can be raised to merit the attention of the Supreme Court," he said.
The CMA and a group of anesthesiologists sued UCLA and the University of California Board of Regents in December 1998, claiming the rule created unfair competition against other anesthesiologists and violated California's laws against the corporate practice of medicine. A Los Angeles County Superior Court judge ordered the practice stopped while the lawsuit went ahead.
Legal experts suggested the CMA has little choice but to appeal, because the appellate court's ruling against the state's major physician lobby all but neutralized the core arguments in its lawsuit.
"Given the court's view, there isn't a lot of leeway in their favor," said Andrew Demetriou, a partner in the Los Angeles firm of Jones, Day, Reavis & Pogue who specializes in physician practice issues. Demetriou said the appellate court's decision is one of the most significant legal clarifications on how medicine may be practiced in a public setting since rulings in the 1950s that allowed county hospitals to hire physicians.
In reversing the lower-court injunction, the appellate court concluded that barring nonfaculty anesthesiologists from practicing at UCLA facilities guaranteed the diverse patient population required to operate a teaching hospital. "The more limits there are on the university's teaching population, the less likely it is that the university's teaching goals can be met," read a section of its 12-page ruling.
While the court acknowledged the physicians might have an "abstract right" to practice at the hospital, it said that "must give way to the greater needs of the community at large."