Allied Health Professionals and Hospital Privileges: An Introduction to the Issues

Accreditation Manual for Hospitals 1982 Edition (Joint Commission on Accreditation of Hospitals, Chicago, 11.) (1981) at 211 (glossary).

Id. at 96. The author firmly believes that application of the term “allied health professional” to podiatrists is incorrect, for reasons that are given in the text. For purposes of this article, however, the terms will be used generally to include podiatrists. There is also a separate section devoted to nurse anesthetists in the JCAH manual. Id. at 4.

Specific information on podiatric training and residencies can be obtained by contacting the American Podiatry Association, 20 Chevy Chase Circle, N.W., Washington, D.C. 20015. Much of this information is compiled in a booklet, The Role of Podiatry With Hospitals which the APA will make available upon request. Specific descriptions of podiatric surgery on a technical basis are provided in Model Screening Criteria for the Review of Surgical Procedures and Associated Care Rendered by Podiatrists, (American Podiatry Association and the Department of Health, Education and Welfare, Washington, D.C.) (July 1975).

This type of information is provided by the American College of Nurse-Midwives, 1012 Fourteenth Street, N.W., Suite 801, Washington, D.C. 20005.

The forum for this educational process is usually in hospital committees that hear requests for privileges from health care providers or appeals of denials of privileges. All such appeals generally terminate with the governing body, e.g., Board of Directors, which has ultimate responsibility for running the hospital. See Governing Body in Accreditation Manual for Hospitals, supra note 1, at 51–56. Health care providers contemplating litigation are well-advised to pursue appeals to the governing body as a decision of a hospital may neither be “official” nor “final” without its ruling.

42 U.S.C. §1395.

42 U.S.C. §1395 x(r).

See, e.g., 42 C.F.R. §405.1023 (1981). These regulations provide that “physicians” should be awarded privileges appropriate to their specialty.

Va. Code §32.1-134.2 (1979) (grant or denial of privileges to podiatrists must be based on applicants' license, judgment, competence and experience).

Accreditation Manual for Hospitals, supra note 1, at 97.

Va. Code §32.1-134-2 (1979).

Va. Code §18.2-499 (1975).

See, e.g., Va. Code §32.1-134-1 (1979).

42 U.S.C. §1983.

See, e.g., Shaw v. Hospital Authority of Cobb County, 507 F.2d 625 (5th Cir. 1975).

Federal courts have been resistant to utilizing claims of denial of equal protection under 42 U.S.C. §§1983 and 1985 for other than traditional minorities (race, sex) for fear that these statutes can be used to create a general federal tort law for any group claiming to be a minority. See Canlis v. San Joaquin Sheriff's Posse Commitatus, 641 F.2d 711 (9th Cir. 1981).

During the judicially activist 1950s and 1960s, Hill-Burton had been utilized as a tool to prevent racial discrimination against health care providers. See, e.g., Simpkins v. Moses H. Cone Memorial Hospital, 323 F.2d 959 (4th Cir. 1963). Many federal courts are now retreating from this activism, particularly as constitutional claims of health care providers have shifted from equal protection to due process denials. The Fourth Circuit Court of Appeals has itself retreated from its use of Hill-Burton to provide state action, holding that “state action” does not flow from these funds. See Modaber v. Culpepper Memorial Hospital, 674 F.2d 1023 (4th Cir. 1982).

See 15 U.S.C. §§1, 2.