Q: During my divorce I got a restraining order to stop my ex from selling off assets at a cut-rate. My lawyer explained that a court can step in to freeze situations while they are being settled if letting them continue would cause irrevocable harm that cannot be stopped any other way. I don’t understand why doctors can’t do that if a hospital refuses to renew their privileges and that would ruin their practice irrevocably.

A: Real or chattel property that you have a pre-existing legal claim on is different from an untenured privileges agreement, which is discretionary with the hospital. That you base where you would open your practice on having acquired privileges at that facility does not give you a vested right to stay there. A court can step in to stop deliberate waste of existing property but at the end of a contractual term for privileges there is no obligation to renew the contract and so nothing for a court to act on.

However, there is a situation in which such an Order can be sought: an expulsive action that is engaged in summarily while the contract is still in force and before evaluation is completed.

A facility can terminate a doctor summarily if there is a cause, such as loss of licensure or malpractice coverage, that makes them unable to practice, or if they act to a patient or staff member in a way that indicates that they are an imminent threat.  However, suppose that a doctor were alleged to have fraudulently billed twice for the same procedure. While it could be appropriate for the hospital to suspend the doctor’s billing while it investigates the allegation expeditiously, this is not the sort of allegation that requires immediate removal from the staff during that investigation, let alone permanently, and  the doctor could seek an Order to prevent this summary action before their practice is irrevocably harmed.

Doctors who have been kicked out of PPO’s because they are perceived by the payor to be rendering care that is too expensive have also been able to interpose such Orders as soon as they receive notice of the pending action and before the actual termination occurs. An Order like this does not mean that the doctor will actually prevail but it gives them a chance to try to get an audit and to assert their contractual rights.

Timing is critical because there is a substantial logistical difference between basically hitting the “pause button” while an agreement is still in force and trying to reverse a full cancellation of privileges or of a contract. A doctor in such a situation should let no grass grow under their feet without consulting an attorney about their options.