Cases with opposing interpretations on this issue were decided within the past month. Heretofore, the basic question had been whether medical staff bylaws constituted contracts under state law. The majority of courts deciding these cases have concluded that medical staff bylaws were valid contracts. In the states with the opposite holdings, the basic theory was that bylaws merely implement state imposed licensing requirements and therefore lacked the fundamental requirement of “consideration.”

These recent cases more closely examine the actual wording of the bylaws.

In Smith v. Adventist Health System, a California state appellate court distinguished prior California decisions rejecting the contract theory by noting that the medical staff bylaws in question specifically stated that they did constitute a contract, and could therefore be enforced as such.

Conversely, a state appellate court in Indiana reached the opposite conclusion in W.S.K. v. M.H.S.B. The Indiana court also distinguished prior state case law; in this instance, Terre HauteRegionalHospital v. El-Issa, which held that medical staff bylaws could constitute a contract. This court reached the opposite conclusion because, as in Smith v. Adventist Health, the bylaws specifically addressed that issue. However, in this case the language stated:

“These Bylaws and the related Manuals shall not be deemed as a contract of any kind between the Board of Trustees and the Medical Staff or any individual member thereof.”