{
  "id": 8527323,
  "name": "DR. TERRY C. CLAYCOMB v. HCA-RALEIGH COMMUNITY HOSPITAL",
  "name_abbreviation": "Claycomb v. HCA-Raleigh Community Hospital",
  "decision_date": "1985-08-20",
  "docket_number": "No. 8410SC1322",
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  "last_updated": "2023-07-14T20:46:57.071049+00:00",
  "provenance": {
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  "casebody": {
    "judges": [
      "Judges Wells and Johnson concur."
    ],
    "parties": [
      "DR. TERRY C. CLAYCOMB v. HCA-RALEIGH COMMUNITY HOSPITAL"
    ],
    "opinions": [
      {
        "text": "COZORT, Judge.\nThe question raised by this appeal concerns whether G.S. 131-126.11A, recodified at G.S. 131E-85, requires a privately owned hospital to review the qualifications of a podiatrist applying for staff privileges even though the hospital administration has decided to close the medical staff to additional podiatrists. The trial court ruled that G.S. 131-126.11A confers no right to a practitioner to have his application for staff privileges reviewed and dismissed this action for lack of subject matter jurisdiction.\nThe facts underlying the present controversy are as follows: On 31 July 1979, the Board of Trustees of the defendant hospital decided to close the medical staff to podiatrists. The hospital at the time had extended staff privileges to one podiatrist. The Board\u2019s decision was based on the determination that the services of one podiatrist were adequate to meet the hospital\u2019s commitment to meet the podiatric needs of the community.\nOn 30 November 1979, the plaintiff podiatrist, Dr. Terry C. Claycomb, applied for staff privileges at the defendant hospital. Because the medical staff was closed to additional podiatrists, Dr. Claycomb\u2019s application was not accepted for processing though it remained on file.\nIn 1981, the General Assembly enacted the Hospital Licensing Act and in pertinent part provided:\nThe granting or denial of privileges to practice in hospitals to licensed physicians and other practitioners licensed by the State of North Carolina to practice surgery on human beings, and the scope and conditions of such privileges, shall be determined by the governing body of the hospital based upon the applicant\u2019s education, training, experience, demonstrated competence and ability, judgment, character and the reasonable objectives and regulations of the hospital in which such privileges are sought. Nothing in this Article shall be deemed to mandate hospitals to grant or deny to any parties privileges to practice in said hospitals.\nG.S. 131-126.11A (1981). This Act was repealed by Session Laws 1983, c. 775, s. 1, effective 1 January 1984, and replaced by the Hospital Licensure Act, G.S. 131E-75, et seq. The corresponding statute, G.S. 131E-85, differs from the repealed statute, G.S. 131-126.11 A, by specifically extending its application to \u201cphysicians . . . dentists and podiatrists\u201d rather than generally to \u201clicensed physicians and other practitioners.\u201d\nFollowing the passage of G.S. 131-126.11A, Dr. Claycomb renewed his application for staff privileges with the defendant hospital. By this time, the Board of Trustees had also adopted a three-year residency requirement for all users of the hospital\u2019s operating rooms, including podiatrists. By letter in October of 1982, the plaintiff was informed that the medical staff was still closed to podiatrists and that in any event the hospital required a three-year surgical residence by podiatric applicants. In May of 1983, the plaintiff again attempted to obtain staff privileges but learned that his application had never been processed and that he had no right of appeal or right to a hearing on the hospital\u2019s decision not to review his application.\nDr. Claycomb filed this action in August of 1983, seeking a declaratory judgment construing G.S. 131-126.11A, injunctive relief, and actual damages. Pursuant to the defendant\u2019s Rule 12(b)(6) motion, the plaintiffs claim for damages was dismissed on the grounds that it was barred by the statute of limitations, G.S. 1-52. Later, pursuant to the defendant\u2019s Rule 12(b)(1) motion, the plaintiffs remaining claims were dismissed on the grounds that the court lacked subject matter jurisdiction. The trial court concluded as a matter of law that the State had \u201cno legitimate interest in the denial of medical staff privileges by a private hospital to any individual practitioner\u201d and that G.S. 131-126.11A \u201cdoes not mandate that a private hospital follow any particular procedure or reach any particular result as to an application for staff privileges.\u201d\nThe plaintiff on appeal contends that the police power of this State extends to the regulation of private hospitals, including the granting of staff privileges. The defendant argues that G.S. 131-126.11A does not impose a requirement that practitioners be granted privileges or even that their applications be reviewed, but merely establishes a framework to insure that if staff privileges are granted they are extended only to qualified practitioners.\nIn Cameron v. New Hanover Memorial Hospital, 58 N.C. App. 414, 449, 293 S.E. 2d 901, 922, cert. denied, 307 N.C. 127, 297 S.E. 2d 399 (1982), this Court, construing G.S. 131-126.11A, stated no court should substitute its judgment for that of the hospital board which is charged with the responsibility of providing a competent staff of doctors. The Cameron court further related that as long as staff selections were administered with fairness, geared by a rationale compatible with hospital responsibility, and unencumbered with irrelevant considerations, a court should not interfere. Id. We believe these Cameron principles are applicable in the instant case.\nSurely, the State has a legitimate interest in seeing the health, safety and general welfare of the public promoted and protected. A-S-P Associates v. City of Raleigh, 298 N.C. 207, 258 S.E. 2d 444 (1979). Thus, the operation of a hospital, whether publicly or privately owned, is subject to State regulation. Foster v. Medical Care Commission, 283 N.C. 110, 195 S.E. 2d 517 (1973). However, the State\u2019s involvement in the operation of a hospital should extend only to the point of insuring that the community\u2019s medical needs are competently and sufficiently being met. As recognized in Cameron, the right to enjoy staff privileges is not absolute, but is subject to the standards and objectives set by the hospital\u2019s governing body. Id. at 453, 293 S.E. 2d at 924. Therefore, we hold that G.S. 131-126.11A does not grant a medical practitioner the right to have his application for staff privileges considered by a hospital if the hospital\u2019s governing board has made a decision to deny further staff privilege requests which is reasonably related to the operation of the hospital, consistent with its responsibility as a community hospital, and administered fairly.\nIn the present case, the court below dismissed the action on the basis that it lacked subject matter jurisdiction over the complaint. We hold this ruling was in error. As a matter of procedure, the question of whether G.S. 131-126.11A confers a right upon the plaintiff to have his application considered is not an issue of subject matter jurisdiction, but involves whether the complaint states a claim upon which relief can be granted. See generally Dale v. Lattimore, 12 N.C. App. 348, 183 S.E. 2d 417, cert. denied, 279 N.C. 619, 184 S.E. 2d 113 (1971). Therefore, the granting of the defendant\u2019s Rule 12(b)(1) motion was improper.\nIn any event, the plaintiffs action should not have been dismissed, even on a proper Rule 12(b)(6) motion. Although G.S. 131-126.11A does not. require that the plaintiffs qualifications for staff privileges be reviewed, it does require that the denial of those privileges be \u201cbased upon . . . the reasonable objectives and regulations of the hospital.\u201d G.S. 131E-85. Thus, the statute does allow the reasonableness of a hospital\u2019s actions to be reviewed. Because North Carolina courts have been charged with this narrow responsibility of determining whether a hospital\u2019s actions and objectives are reasonable, Cameron, supra, at 449, 293 S.E. 2d at 922, we hold the complaint does state a claim upon which relief can be granted. We, therefore, reverse the trial court\u2019s conclusion of law that it lacked jurisdiction over the matter and remand this case for further proceedings not inconsistent with this opinion. The plaintiff will have the burden of proving that the hospital\u2019s conclusion that \u201cthe services of one podiatrist were adequate to meet . . . the podiatric needs of the community\u201d was arbitrary, capricious or discriminatory, and that its decision to close the medical staff to additional podiatrists was: (1) not reasonably related to the operation of the hospital; (2) not rationally compatible with the hospital\u2019s responsibility; or (3) based on irrelevant considerations. See Davidson v. Youngstown Hospital Assoc., 19 Ohio App. 2d 246, 250 N.E. 2d 892 (1969). If the defendant hospital\u2019s actions are determined to be unreasonable or irrational, the plaintiff is entitled under the statute to have his application for staff privileges reviewed and a decision, granting or denying him staff privileges, based on the other criteria provided in the statute such as his \u201ceducation, training, experience, demonstrated competence and . . . character.\u201d G.S. 131E-85.\nReversed and remanded.\nJudges Wells and Johnson concur.",
        "type": "majority",
        "author": "COZORT, Judge."
      },
      {
        "text": "Judge WELLS\nconcurring.\nIn my opinion, the important and dispositive question in this case is whether governing boards of licensed hospitals may deny staff privileges to licensed practitioners except upon finding that such practitioners applying for staff privileges do not meet the hospital\u2019s standards for \u201ceducation, training, experience, demonstrated competence and ability, judgment, character, and the reasonable objectives and regulations of the hospital, including, but not limited to appropriate utilization of hospital facilities, see N.C. Gen. Stat. 131E-85A (1983 Cum. Supp.). Accordingly, appellant in this case is entitled to have his application considered against such standards.",
        "type": "concurrence",
        "author": "Judge WELLS"
      }
    ],
    "attorneys": [
      "J. Melville Broughton, Jr., and William Woodward Webb for plaintiff appellant.",
      "Jordan, Brown, Price & Wall by John R. Jordan, Jr., and Joseph E. Wall for defendant appellee."
    ],
    "corrections": "",
    "head_matter": "DR. TERRY C. CLAYCOMB v. HCA-RALEIGH COMMUNITY HOSPITAL\nNo. 8410SC1322\n(Filed 20 August 1985)\n1. Hospitals \u00a7 6\u2014 application for hospital staff privileges\nG.S. 131-126.11A (now G.S. 131E-85) does not grant a medical practitioner the right to have his application for staff privileges considered by a hospital if the hospital\u2019s governing board has made a decision to deny further staff privilege requests which is reasonably related to the operation of the hospital, consistent with its responsibility as a community hospital, and administered fairly.\n2. Hospitals \u00a7 6\u2014 denial of hospital staff privileges \u2014 judicial review\nG.S. 131-126.11A (now G.S. 131E-85) requires that the denial of hospital staff privileges be \u201cbased upon . . . the reasonable objectives and regulations of the hospital\u201d and thus allows judicial review of the reasonableness of a hospital\u2019s denial of such privileges.\n3. Hospitals \u00a7 6\u2014 denial of staff privileges to podiatrists \u2014 burden of proving unreasonableness\nPlaintiff podiatrist had the burden of proving that defendant hospital\u2019s denial of staff privileges to additional podiatrists because \u201cthe services of one podiatrist were adequate to meet . . . the podiatric needs of the community\u201d was arbitrary, capricious or discriminatory, and that the hospital\u2019s decision to close the medical staff to additional podiatrists was (1) not reasonably related to the operation of the hospital, (2) not rationally compatible with the hospital\u2019s responsibility, or (3) based on irrelevant considerations.\nJudge Wells concurring.\nAPPEAL by plaintiff from Barnette, Judge. Order entered 25 October 1984 in Superior Court, Wake County. Heard in the Court of Appeals 6 June 1985.\nJ. Melville Broughton, Jr., and William Woodward Webb for plaintiff appellant.\nJordan, Brown, Price & Wall by John R. Jordan, Jr., and Joseph E. Wall for defendant appellee."
  },
  "file_name": "0382-01",
  "first_page_order": 416,
  "last_page_order": 420
}
