Ray v. Pinnacle Health Hospitals, Inc. is an interesting physician discrimination case, not because it presents new concepts, but more so because of the use of the hospital’s quality assurance data in the discovery and summary judgment process.

The Third Circuit is merely affirming the grant of summary judgment by the United States District Court for the Middle District of Pennsylvania in favor of the hospital. The opinion recites the usual burden of proof:

(a)        The plaintiff must establish a facia case;

(b)        The burden shifts to the defendant hospital to identify a legitimate nondiscriminatory reason for its action; and

(c)        The plaintiff physician must then show by a preponderance of the evidence that the hospital’s explanation was a mere pretext for discrimination and not a real motive for adverse employment actions. 

For purposes of analysis, the Third Circuit simply assumed that the physician had presented a prima facie case. 

In rebuttal, the hospital “tendered evidence that the review consisted of a preexisting, multi-level process involving at least 37 different staff members drawn from across Pinnacle’s 800 member staff that represented at least 46 different countries.” In other words, the hospital relied upon the fact that it followed its peer review process and that its staff was already culturally and ethnically diverse. That, along with the evidence regarding the six separate incidents involving Dr. Ray, therefore justified the conclusion that Dr. Ray was not being discriminated against because of his race or national origin. 

An interesting component of the case is that the opinion mentions that the hospital produced during discovery more than 6,000 pages of quality assurance information over a six year period involving 152 physicians. There is no evidence in this opinion of the typical dispute regarding the confidentiality of the peer review information, which may simply have been a byproduct of the “neutrality” of the information. 

Dr. Ray was able to identify two cases in which Caucasian physicians with serious incidents were allegedly treated more favorably than Dr. Ray. The court skipped the comparative analysis of whether the performance was actually worse than Dr. Ray’s by concluding that, even if it had been worse than Dr. Ray’s, the fact that Dr. Ray could identify only two instances over a six year period and given the number and extent of the review involved for all of these other physicians, there was insufficient evidence to conclude that the hospital’s actions were merely a pretext.