Doctors Groups Underwrite Ventura Suit

State and national physicians groups have donated more than $100,000 to Ventura doctors to underwrite a lawsuit against Community Memorial Hospital that they see as key in a nationwide effort to reaffirm the role of doctors as patient advocates in medical centers.

“We’re going to spend whatever it takes until the integrity of the medical staff has been reestablished,” said Jack Lewin, chief executive of the California Medical Assn. “A medical staff operates under a distinct set of defining principles, and every one has been violated in Ventura.”

Community Memorial has been embroiled in an internal fight for more than a year, as the 242-bed hospital has tightened controls over its medical staff and physicians have bristled at what they consider an erosion of their rights. After attempts at mediation, a group of doctors led by a majority of the medical staff executive committee filed suit in April.

Now, as both sides prepare for a pivotal court hearing today, physician leaders announced that the California and American medical associations have each contributed more than $50,000 to press the Ventura case.

“I think this raises a question,” said Lowell Brown, a Los Angeles lawyer specializing in health-care issues who is representing Community Memorial. “Here we have a single community hospital in a small city in California, and it has attracted the attention of the largest medical association in the world. Why?”

Brown said the medical associations are interested not because the traditional role of doctors in hospitals is being challenged, but because it’s in their interest to stoke controversy.

“Only 35% of the doctors in California are members of the [California Medical Assn.] and frankly, they make quite a name for themselves when they stir up strife, which they’re doing in spades,” he said. “I’ve never seen them more involved in a case.”

The state medical association’s Lewin said the doctors groups are supporting the Ventura doctors so strongly because Community Memorial has taken a radical position in refusing to recognize the medical staff as a self-governing part of the hospital or to respect its role as watchdog on behalf of patients.

“If this were to become some sort of legal precedent, it could cause a cataclysmic interruption of what are typically healthy and constructive relationships between physicians and hospitals,” Lewin said. “Occasionally, we have a flare-up, but this is really an extreme case in Ventura.”

The state medical association is, in fact, working to ease tensions and improve relations, he said, by talking with California’s 500-member hospital association to iron out a set of principles that both sides can embrace to avoid the kind of rancor that has occurred in Ventura. Yet, attorneys for the hospital group, the California Healthcare Assn., filed a legal brief Monday supporting Community Memorial. “The case is one of vital importance to the operation of hospitals throughout the state of California,” the brief states.

“This particular circumstance has gotten completely out of control,” Lewin said. “We have to wage a legal battle to protect the doctors, but which seems extremely counterproductive to everybody.”

In the Ventura case, doctors specifically claim that administrators tried to rig a staff election, adopted an 18-page code of conduct to stifle dissent, implemented a conflict-of-interest policy to disqualify selected physicians from leadership positions, and illegally allowed physicians to practice at the hospital without the staff’s review.

Hospital attorneys maintain that Community Memorial’s medical staff has no legal standing or authority beyond that granted by the facility’s board of trustees.

The medical staff functions as an advisory group only, they have argued.

“This is one of the biggest issues yet to be decided in California,” said Brown, the hospital’s lawyer. “But if you look at all of the case law, I think it’s clear how the court should come down.... The board of trustees is supreme. The medical staff is subject to the board in every way.”

Indeed, the hospital maintains that the dispute is purely financial and is being pressed by doctors with conflicts of interest -- such as competing in-office surgery units -- that take business away from the hospital.

Under Community Memorial’s new policy, such doctors could not be elected leaders of the medical staff or vote in staff elections.

The physicians, however, have said that any conflicts are minor and that the key issue is their autonomy, which is well-established in law, industry regulation and practice.

The hospital is to argue its case for dismissing the lawsuit without trial before county Superior Court Judge Henry Walsh this morning.