In his quest for Caesarean section privileges, California family physician Eric Runte, MD, is gearing up for a July 1 trial in federal court.
In April 1996, Dr. Runte filed an antitrust lawsuit against Sonora Community Hospital (SCH) and three OB-Gyns. The case recently was amended to include defamation by one of the OB-Gyns.
Dr. Runte's attorney, Barbara Hensleigh, Esq., says the defamation claim was based on statements the OB-Gyn made about Dr. Runte outside of court and outside of any hospital peer review setting--statements impugning Dr. Runte's veracity and competency. Ms. Hensleigh contends those statements were made to garner support for excluding Dr. Runte from performing C-sections.
Dr. Runte completed a family practice residency with training in obstetrics at Ventura Medical Center in Ventura, CA. During his residency, he performed 110 C-sections and was the primary surgeon in 70 of those. He directs the Primary Care Clinic at Tuolumne General Hospital in Sonora. Because Tuolumne General doesn't have a birth center, he delivers babies at SCH.
While his application for C-section privileges was pending at SCH, the hospital adopted a policy precluding FPs with training in maternity care, including C-sections, from obtaining C-section privileges. The hospital sought advice from a joint task force of FPs and OB-Gyns, but then ignored its recommendation that C-section privileges not be specialty-based.
Ms. Hensleigh says the two sides have exchanged offers but are far from reaching a settlement out of court. "One of the offers was that Eric perform 250 C-sections under proctoring by the defendant obstetricians," she says. "He could subtract from that the C-sections he had performed as a primary surgeon during his residency. I figured out that it would probably take him about nine years of proctoring before he could get C-section privileges. That's so outrageous, it ought to raise everybody's hackles."
She adds, "One of our criteria for settlement is that any policy should be based on demonstrated competency, training, and experience, and shouldn't have criteria discriminatory against family physicians."
The AAFP has offered to serve as a resource in support of the California AFP in the lawsuit.
The CAFP has established a defense fund for members entrenched in privileging battles. So far, the chapter has collected $44,000 from more than 20 chapters and hopes to reach its goal of $50,000. Dr. Runte's case is the only one currently receiving money from the fund, but CAFP Executive Director Susan Hogeland says this lawsuit will set a precedent. "We do this on behalf of all family physicians, not just Dr. Runte," she says. "It is a warning shot across the bow."
By Sharon Dickinson Dent, Associate Editor
