For the week of January 8 - 14, 2003

Pediatrician protests dismissal from St. Luke’s Medical Center

---

By GREG MOORE
Express Staff Writer

Dr. Marel Hanks, the Wood River Valley’s only pediatrician, contends that an unfair procedure was used to strip her of her privileges at St. Luke’s Wood River Medical Center last summer.

Hanks, who has been practicing locally for eight years, still maintains an office in Ketchum. However, a doctor must hold hospital privileges to admit patients or treat them there. Since Hanks lost her privileges on July 12, care of pediatric patients at the hospital has been covered by family practice doctors.

In an interview, Hanks said she had contemplated filing a lawsuit against St. Luke’s to reclaim her privileges and to seek damages, but had recently concluded she could not afford to do so.

When questioned by the Mountain Express in September about Hanks’ termination, St. Luke’s Marketing Director Kerry George said Hanks had "voluntarily relinquished" her privileges. However, letters exchanged among the parties involved indicate that that may not have been the case.

In a dispute statement sent to the National Practitioner Data Bank, which maintains records of disciplinary actions against doctors, Hanks stated that her resignation was obtained by threats made by CEO Bruce Jensen and Medical Executive Committee Chairman Dr. Herb Alexander during a meeting July 12. At the meeting, Hanks was given a copy of a review of two of her cases made by an anonymous doctor outside St. Luke’s. She said in an interview that her resignation was requested on the basis of that report.

"They told me that my privileges would be summarily suspended if I did not immediately resign," she wrote in the dispute statement. "I was very upset. I had been unaware that my privilege status was being evaluated or that two of my cases had been sent for outside review. I asked several times for time to think about this decision, but they refused. They handed me a one-sentence form resignation letter and asked me to sign. They said it would look much better if I resigned versus having my privileges suspended. Reluctantly and under duress, I signed the form resignation letter they had prepared prior to the meeting."

The meeting took place on a Friday. The following Monday, July 15, Hanks delivered a letter to the hospital stating she was withdrawing her resignation.

"I am requesting a short period of time to review this issue with you, and to have another physician review the letter from the expert," she stated. "I am convinced that this decision by the Medical Executive Committee was based on incorrect data and I request an opportunity to bring this to your attention."

In a July 19 letter, Medical Staff Chief Dr. Frank Fiaschetti told Hanks that her request had been denied.

A week later, Hanks’ attorney, Pat Miller wrote to Janine Sarti, chief legal officer of St. Luke’s Regional Medical Center in Boise, that Hanks’ resignation "was not effective because it was obtained by surprise, duress and misrepresentation." Miller requested a hearing for his client under the procedures set forth in the hospital’s medical staff bylaws and Fair Hearing Plan.

In response, Sarti wrote that "relinquishment of privileges is not one of those actions which trigger procedural rights under…the Fair Hearing Plan. …(N)o procedural rights are afforded to a practitioner who relinquishes privileges. To obtain medical staff privileges thereafter requires application for privileges."

In her letter, Sarti acknowledged that Jensen told Hanks during the July 12 meeting "that he intended to summarily suspend her privileges immediately, which he had authority to do under (the Fair Hearing Plan), because he believed that Dr. Hanks’ conduct required that immediate action be taken to prevent danger to life or substantial likelihood of injury to hospital patients."

However, neither of the two cases reviewed by the anonymous expert were ongoing; one had occurred in May 2001 and the other in March 2002. According to Hanks, both patients had recovered from their illnesses.

Efforts by the Mountain Express to determine why "immediate action" was required in Hanks’ case were unsuccessful. George said the hospital was prohibited by state and federal law from discussing the subject. In her letter to Miller, Sarti stated that St. Luke’s "has and will at all times treat matters involving peer review as strictly confidential. Therefore, … employees and members of the Medical Executive Committee will not engage in a discussion of this matter with anyone, including Dr. Hanks."

Robert Meals, a Seattle attorney who specializes in medical peer review cases, and who consulted with Hanks’ attorney, called the hospital’s reliance on legal constraints "nonsense."

"When you have no formal charges, an anonymous review and no hearing, I don’t think state and federal law have a bloody thing to do with it," Meals said in an interview.

Meals contended that confidentiality laws are intended to protect doctors who are the subject of peer review hearings, but are sometimes used by hospitals "to shield them from scrutiny of their own misconduct."

"I think this case is a graphic example of that," he said.

Meals also criticized the method by which St. Luke’s had obtained Hanks’ resignation.

"I don’t think there’s a court in the country that would recognize that as a legally sufficient procedure," he said. "That’s not voluntary, when you threaten somebody with ruining their career if they don’t do what you want in the next 30 minutes. They did something brutal to her that was way over the line."

 

The Idaho Mountain Express is distributed free to residents and guests throughout the Sun Valley, Idaho resort area community. Subscribers to the Idaho Mountain Express will read these stories and others in this week's issue.