In Copeland v. MidMichigan Regional Medical Center, a Michigan State Appellate Court affirmed a trial court’s grant of summary judgment in favor of the Hospital, based upon both HCQIA immunity and a general release signed by the physician as part of the initial medical staff application process. 

These releases are almost universally included in the medical staff application and renewal documents.  However, there may be a basis for challenging the validity of these releases, i.e.,

  1. Contracts of adhesion;
  2. State hospital licensing regulations mandating open medical staffs or baring certain restrictions; or
  3. IRS non profit regulations requiring open medical staffs, although threatening to challenge the tax exempt status of the hospital is unlikely to provide much leverage or little basis for injunctive relief.

Of course, the hospital’s response will certainly be that the medical staff is open as long as everybody signs the required release.  The issue will be whether a local court agrees with that interpretation.  Furthermore, in some circumstances, this issue might also ignite further discussion on the antitrust principal of the essential facilities doctrine.