The American Medical Association is applauding a decision from the Florida Supreme Court which struck down a 2003 state statute, the "St. Lucie County Hospital Governance Law" (HGL). This law allowed hospital board bylaws to supersede medical staff bylaws in any conflicts that arose over privileging, contracting and quality issues. The Florida Medical Association (FMA) had opposed this legislation when it was introduced in the state legislature.

The Florida Supreme Court upheld a 2007 lower appeals court decision in Lawnwood Medical Center, Inc., etc., vs. Randall Seeger, M.D., etc. (2008 Fla. LEXIS 1458), finding the HGL unconstitutional.

The Lawnwood Regional Medical Center & Heart Institute is the largest hospital in St. Lucie County. The facility has had a long-running battle with its medical staff regarding enforcement of the medical staff bylaws, including hospital attempts to remove medical staff officers and to suspend physicians on the medical staff under procedures contrary to those authorized by the medical staff bylaws. The medical staff later defeated these attempts in court. The hospital then lobbied the Florida legislature to enact the HGL, which applied only to hospitals in that county. The law provided that "in the event of a conflict between bylaws of a hospital corporation's board of directors and a hospital's medical staff bylaws, the hospital board's bylaws shall prevail with respect to medical staff privileges, quality assurance, peer review, and contracts for hospital-based services."
How did this law affect the medical staff? Under the Medical Staff Bylaws, the medical staff has an important role to play in reviewing and making recommendations relating to execution, renewing, modifying or terminating an exclusive contract in a new department or service, and the Board would need to have good cause to reject the recommendations of the medical staff. The HGL granted the Board the right to circumvent the recommendation of the medical staff by expressly providing that the Board's bylaws relating to hospital-based services will prevail over any conflicting provisions of the Medical Staff Bylaws.

In addition, the Medical Staff Bylaws provides for a credentials committee consisting of members of the medical staff to review the credentials of new applicants for all categories of staff appointments and clinical privileges and to make recommendations to the Board. The HGL granted the Board the right to override these recommendations, without any meaningful checks or balances.

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