This action seeks to review the validity of the action of the Overlook Hospital Association (Overlook) in denying plaintiffs' applications for appointment to the medical staff.
Plaintiffs ask that Overlook be directed to set up procedures and afford them a hearing on their rejected applications for medical staff appointment. If plaintiffs are denied relief as against Overlook, then they seek to enjoin defendant Town of Westfield (Westfield) from contributing financially to said hospital. They contend that Westfield is violating the due process and equal protection clauses of the Fourteenth Amendment of the United States Constitution by annually contributing to a quasi -public institution which engages in unreasonable, arbitrary and discriminatory practices.
Plaintiffs practice medicine in partnership, specializing in neurosurgery. Dr. Sussman is one of about 18 neurosurgeons in New Jersey certified by the American Board of Neurosurgery, and Dr. Scialabba is one of about 12 other physicians eligible for board certification. Both plaintiffs have exceptional medical and educational backgrounds. It is conceded that their medical competence is not an issue in this case.
Dr. Sussman and Dr. Scialabba formed their partnership in June 1964. Previously Dr. Sussman had offices in Plainfield and Perth Amboy, which plaintiffs now operate together. Both plaintiffs enjoy hospital privileges at Muhlenberg Hospital in Plainfield and Perth Amboy General Hospital in Perth Amboy. Neurosurgery is basically a hospital practice, with the offices being utilized only for short periods of time
for patient consultations. Neurosurgeons receive most of their patients through referrals.
In the summer of 1964 the partnership opened an office in Westfield because there were no other neurosurgeons in that area. The Westfield community is served by both Muhlenberg and Overlook on approximately a 50-50 basis. In the summer of 1964 plaintiffs applied to Overlook for courtesy staff privileges. They felt they could better serve the Westfield community by having privileges at both Muhlenberg and Overlook Hospitals. Many Westfield patients prefer to be hospitalized at Overlook, and Westfield doctors who have staff privileges at Overlook prefer that patients they refer to a specialist be hospitalized at Overlook so that they can attend to their post-operative treatment.
Dr. Sussman was interviewed by the credentials committee of Overlook Hospital on November 17, 1964. The credentials committee minutes reflect that Drs. Erdman, Green, Langgaard and Wagner were present; that the meeting started at 8:15 P.M. and was adjourned at 8:40 P.M., and that Dr. Sussman and a Dr. Bromberg were interviewed and considered by the committee for appointment to the medical staff. The committee recommended that Dr. Sussman's application be denied, noting that he was already on the staff of two hospitals, that he lived in Plainfield, and that Overlook already had four neurosurgeons on its staff: one on the consulting staff, two on the attending staff, and one on the courtesy staff.
On January 19, 1965 Dr. Scialabba was interviewed by the credentials committee. His application was recommended for rejection, the same factors being noted as in the case of Dr. Sussman. Present at this meeting were Drs. Bennett, Erdman, Langgaard, Terhune and Wagner. The minutes reflect that Dr. Scialabba indicated in response to inquiry that he had no interest in working in Overlook on a solo basis without Dr. Sussman. In the course of his testimony before this court, Dr. Scialabba stated that a partnership practice afforded the opportunity for one partner to cover for the
other. Hence, his suggested possible appointment without that of Dr. Sussman would be of no interest to him.
Concerning the interviews of both applicants, the minutes of the credentials committee were respectively accepted by the meetings of the medical staff executive committee. The applications of plaintiffs were then passed on to the joint advisory committee (a committee of laymen and physicians) for their recommendations. This committee considered these applications on March 22, 1965. The minutes of this meeting indicate that the files on the two applicants were carefully reviewed and the recommendations of the credentials committee considered. The same factors noted by the credentials committee were again noted on the record. The joint advisory committee unanimously resolved to recommend to the board of trustees that the applications of Dr. Sussman and Dr. Scialabba be denied.
On March 25, 1965 the chairman of the joint advisory committee presented the applications of Drs. Sussman and Scialabba to the executive committee of the board of trustees of Overlook for their consideration. The minutes of the joint advisory committee were read into the record and made part of the minutes of this committee meeting. The executive committee was reminded that it was its duty to decide upon matters of this kind and not to place responsibility for such decisions on the medical staff. After discussion and questions, it was unanimously resolved that the applications be denied.
Upon being informed of the rejection of his application in a brief letter which assigned no reasons for such rejection, Dr. Sussman wrote to Overlook requesting reconsideration of his and Dr. Scialabba's applications, and an opportunity to appear personally in support of their applications. Dr. Sussman's attorney also wrote, requesting a hearing and advice as to the grounds upon which plaintiffs were rejected. Thereafter, Mr. Robert E. Heinlein, Director of Overlook, telephoned Dr. Sussman and informed him of the reasons for the denial of his application as set forth in the minutes of
the March 22, 1965 meeting heretofore noted. On April 19, 1965 the joint advisory committee decided that since the reasons for the denial recently were communicated to Dr. Sussman, and since the by-laws of the Overlook Hospital Association do not contemplate a hearing on behalf of an applicant not approved for privileges, no further action need or should be taken. On April 22, 1965 the meeting of the full board of trustees of Overlook approved this decision made by the joint advisory committee. All procedures followed concerning the applications of Drs. Sussman and Scialabba strictly conformed with the by-laws of Overlook and the by-laws of the medical staff.
The by-laws of the medical staff of Overlook Hospital, in article III, section 1A, provide as qualifications for appointment that:
"The application for membership on the Medical Staff shall be a graduate with a degree of doctor of medicine of a medical school approved by the American Medical Association, legally licensed to practice in the State of New Jersey, a member of good standing in the medical society of the county in which he is practicing, and shall have established an office in the geographical area served by Overlook Hospital as designated by the Board of Trustees, excepting that appointments to the staff in special services may be made from outside the Overlook area where a vacancy exists that cannot be filled from the Overlook area."
Both Drs. Sussman and Scialabba fulfill all these requirements.
The reasons formally advanced for denying plaintiffs' applications were not the real reason for the denial. It appears that Overlook was disposed to consider Dr. Scialabba's application favorably if it was not bracketed with that of Dr. Sussman. The fact that Overlook already has four neurosurgeons on its staff is not really relevant. Neurosurgeons bring their own patients to the hospital for care, and if Drs. Sussman and Scialabba did not have referral patients of their own to bring to Overlook, they would have no need to use the facilities.
The fact that plaintiffs have medical staff appointments in two other hospitals is also not particularly relevant except in the sense that they will not be deprived of the opportunity to make a living by the denial of their applications. There was some suggestion that membership on two other hospitals is enough. However, other neurosurgeons on Overlook's staff have at least three other appointments to hospitals, with Dr. Green on the staff of nine others and Dr. Liss on eight.
The fact that plaintiffs live in the Plainfield area is not of any consequence. The important factor is that plaintiffs have an office in Westfield which is in the geographic area served by Overlook. The testimony indicates that without hospital privileges at Overlook plaintiffs will not be able efficiently to serve the Westfield community, or effectively develop a Westfield practice.
The essential reason for the denial of plaintiffs' applications was the alleged "personality problems" of Dr. Sussman. Overlook sent questionnaires to the hospitals with which the applicants were or had been affiliated. On August 19, 1964 Mr. Robert S. Hoyt, Administrator of Perth Amboy General Hospital, returned this questionnaire answering the following questions in the negative: "Does he get along well with other members of the Medical Staff as well as the nursing staff? Did he follow hospital ...