Radiation Therapy Oncology, P.C. v. Providence Hospital

906 So. 2d 904, 2005 Ala. LEXIS 10, 2005 WL 78756
CourtSupreme Court of Alabama
DecidedJanuary 14, 2005
Docket1022099
StatusPublished
Cited by2 cases

This text of 906 So. 2d 904 (Radiation Therapy Oncology, P.C. v. Providence Hospital) is published on Counsel Stack Legal Research, covering Supreme Court of Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Radiation Therapy Oncology, P.C. v. Providence Hospital, 906 So. 2d 904, 2005 Ala. LEXIS 10, 2005 WL 78756 (Ala. 2005).

Opinions

PER CURIAM.

Radiation Therapy Oncology, P.C. (“RTO”), and the physicians employed by RTO — Dr. Ken Ellingwood, Dr. Greg Cotter, and Dr. Rod Krentel — appeal from a summary judgment entered for Providence Hospital in the Mobile Circuit Court.

I. Facts

A. The Parties

RTO is a private oncology group employing radiation oncologists Dr. Elling-wood, Dr. Cotter, and Dr. Krentel (“the RTO physicians”). The RTO physicians have medical-staff membership and privileges to see patients and to consult with physicians at the three hospitals affiliated with the University of South Alabama— Providence Hospital and Springhill Medical Center in Mobile, and Thomas Hospital in Fairhope.1

Providence Hospital (“Providence”) is an Alabama nonprofit corporation that operates a private hospital in Mobile. Providence’s controlling shareholder is Ascension Health. Providence’s corporate purpose, as stated in its articles of incorporation, is to provide “health care to the community it serves, with a special concern for the sick and poor and, to the extent financial resources permit, to provide charity care to persons in need.” From the mid-1980s until 2001, Providence provided an oncology center at the hospital at which the RTO physicians practiced radiation oncology.

Seton Medical Management, Inc. (“Seton Medical”), is an Alabama nonprofit cor[907]*907poration whose controlling shareholder since 1995 has been Seton Health Corporation of South Alabama, Inc. (“Seton Health”), an Alabama nonprofit corporation whose controlling shareholder is Ascension Health.

Seton Medical owns and operates professional practices for physicians, and it maintains offices for the physicians in those practices on property adjacent to Providence. Seton Medical is what is commonly referred to as an “office-based practice,” because it is a corporation separate from a hospital and operates outside the hospital. In 2001, Providence transferred ownership of its oncology center to Seton Medical. Since the transfer Seton Medical has operated the oncology center as an office-based practice, providing patients an integrated system of cancer care, including medical oncology and radiation oncology, in one office and from one staff.

B. Providence’s Corporate Authority

Providence’s articles of incorporation provide that “[t]he business, property, and affairs of the Hospital shall be managed and controlled by the Board of Directors in accordance with the policies established by the Corporate Member.” Moreover, the articles allow for corporate bylaws and bylaws pursuant to which any medical staff operates (“the medical-staff bylaws”). The corporate bylaws provide that the business, property, and affairs of Providence shall be managed and supervised by a board of directors (“the board”) and that the board’s powers include the power to approve and recommend the sale or transfer of Providence’s assets. Additionally, Providence’s corporate bylaws state that the medical staff has only “recommendation” authority as to appointments, granting or reducing clinical privileges, disciplinary actions, matters relating to professional competency, and certain other matters. Indeed, the corporate bylaws provide that the board must approve any proposed medical-staff bylaws before those bylaws are effective. The corporate bylaws also provide that the board has final authority on all actions of the medical staff, stating that “[t]he medical staff bylaws must include provisions for a physician to appeal to the Board of Directors as the final authority on actions of the medical staff.”

C. The Medical-Staff Bylaws

The medical-staff bylaws, which the board approved, provide in the preamble that the bylaws “are adopted in order to provide for the organization of the medical staff ... and to provide a framework for self-government” for the medical staff. Those bylaws also provide that the physicians who are part of the medical staff accept their privileges subject to the corporate bylaws. The medical-staff bylaws state:

“Membership is not a right of any person. Membership on the medical staff of the hospital is a privilege that shall be extended only to professionally competent physicians ... and as required by Providence Hospital.”

Additionally, the medical-staff bylaws provide: “[T]he ongoing professional responsibilities of each member of the medical staff include: abiding by the medical staff bylaws and medical staff rules and regulations, and Providence Hospital policies and procedures.” Like the corporate bylaws, the medical-staff bylaws recognize that the medical staff has recommendation authority, while the board has the final authority, on all staffing decisions, including appointment of medical staff, denial of appointments, and revocation of appointments.

The medical-staff bylaws further set out the due-process procedures to be used when the board makes a decision that may adversely affect the exercise of staff privileges at Providence by a physician on the [908]*908medical staff. The medical-staff bylaws provide that the hearing conducted pursuant to those due-process procedures constitutes a “peer review committee” under the Code of Alabama 1975, and the Health Care Quality Improvement Act of 1986, 42 U.S.C. § 11101 et seq., when it is used to “evaluate[], recommend[], or take[] action based on the competence or professional conduct of an individual physician” and when it “affects or may affect the clinical privileges or membership on the medical staff of any physician.” Additionally, the language in the medical-staff bylaws establishes that it is a physician’s conduct, and not the hospital’s conduct, that is intended to be reviewed or defended under the bylaws.

D. The Board’s Decision to Transfer the Oncology Program

In 1997 or 1998, Providence began considering alternatives to the structure of its then existing oncology program. At the time, services to cancer patients were being delivered from different locations, and the medical-oncology and radiation-oncology departments at Providence were separate and distinct departments. During this period, the relationship between the radiation oncologists and the medical oncologists practicing at Providence was poor.

The board determined that Providence needed to establish an integrated and unified cancer-care center where both radiation-oncology and medical-oncology services would be delivered to patients from one location. The board also determined that it was in the best interest of Providence to employ radiation oncologists who would be dedicated to practicing solely at Providence to eliminate any problem caused by a lack of coverage or delays in rendering patient services.

Over the course of approximately two years, Providence, with the assistance of Cancer CarePoint, an independent cancer-care consulting firm, conducted a study of the oncology program at Providence to determine how the proposed cancer-care center could become the best oncology program and provide the best patient care in the area. The study included a review of oncology-related data and confidential interviews with physicians and staff.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
906 So. 2d 904, 2005 Ala. LEXIS 10, 2005 WL 78756, Counsel Stack Legal Research, https://law.counselstack.com/opinion/radiation-therapy-oncology-pc-v-providence-hospital-ala-2005.