Can doctors lose their source of income in this Era of hospital mergers? Unbelievable, but yes. Let me tell you about a case that was so smooth that most doctors did not even get an attorney to protect their license-an investment, according to some estimates of a half million dollars of personal or parental funds or loans.

In one community in California, 200 bed hospital A purchased 100 bed hospital B. When they received the new license for the combined hospitals, hospital A and hospital B ceased to exist and a new hospital C was born. Rather than grandfather in the medical staffs of hospitals A and B, the new combined hospital C (which in reality was the team from hospital A) found an easy way to get rid of all undesirable physicians. This new hospital-new in license only since the physical plants of both continue to function as before-sent a letter to each member of the medical staff stating that their privileges would cease at a certain date. They were advised that they should immediately apply to the new hospital C. This meant new application forms, credentials, letters of reference and documentation of training. All the “favored doctors” were promptly given privileges in the new combined hospital C.

There were seven doctors who received brief letters that privileges could not be granted until further review. Two of the seven doctors obtained immediate legal counsel to represent them in this attempted professional homicide. The other five said they would wait and obtain legal counsel only if they were unsuccessful in the final review process.

The two doctors with legal counsel obtained prompt medical staff privileges. The other five were denied privileges. At this time they sought legal counsel. The lawyers told them that if they had represented them from the start they could have saved their privileges with as little as 20 hours of work or $6,000, precisely what the first two doctors experienced. Now they would need a retainer of $60,000 for 200 hours of work, and the chance of success would probably be less than 50%. If unsuccessful, an appeal to the courts would require at least $300,000 for the first 1000 hours.

But wait, there’s more. Each hospital is required to notify the National Data Bank of any adverse action. Attorney, David M Galie, formerly with the California Medical Board, has called the National Data Bank a permanent tomb for doctors, even for those who made administrative errors not medical errors or who fell out of favor with those in power for non-medical reasons.

It is important that physicians consider hostile activity from hospitals as attempted professional homicide and protect themselves accordingly, unless they prefer an “indecent burial” at the National Data Bank.

Three of the five doctors left town and found a new environment in which to practice. They were able to convince their new hospitals of their credentials and on last report were doing fine. The two that stayed in the community obviously never set foot inside a hospital again. They kept their license since the Medical Board did not see any professional problems. But they scratched a living doing non-mainstream medical jobs in convalescent hospitals and clinics. An unfortunate burial.