Understanding Judicial Review of Hospitals' Physician Credentialing and Peer Review Decisions

Abstract

The article discusses the various legal theories available to physicians whose hospital privileges have been limited or revoked by a hospital through a hospital's credentialing or peer review processes. The article reviews the history of the hospital-physician relationship and discusses the sometimes competing interests of physicians, hospitals, and the public. The article distinguishes judicial review of public hospital physician credentialing decisions which involve constitutional due process and equal protection rights, from judicial review of private hospital physician credentialing decisions which do not. The article identifies and discusses the breach of contract theory based on hospital medical staff bylaws; common law theories rooted in fiduciary duties and common law fair procedure; and state statutory rights affording immunities and procedures for hospital credentialing decisions and imposing judicial standards of review.

Keywords: hospital, physician, credentialing, peer review, judicial review