By Erica Shelley Nelson and Brennen Johnson
In Sambasivan v. Kadlec Medical Center, Division III of the Washington State Court of Appeals, overturned the dismissal of a doctor’s racial discrimination and retaliation claims. The Indian doctor sued the Hospital after it implemented a proficiency standard that prevented him from practicing his specialty. The trial court dismissed his claims, finding that the doctor lacked the necessary relationships with the Hospital to allow his lawsuit. However, the Court of Appeals reversed that decision, holding that such claims could be brought when the Hospital interfered with the doctor’s right to make additional contracts with the Hospital and obtain new patients when the doctor was acting as an independent contractor for the Hospital in certain functions.
Doctor Venkataraman Sambasivan, a certified interventional cardiologist with his own private practice, obtained staff privileges from the Hospital in 2001. In 2008, when his clinical privileges were up for renewal, the Hospital hired an outside professional to review cases of the four interventional cardiologists then on staff. During the process, the doctor began to suspect he was being treated differently than the other three cardiologists, and as a result brought a lawsuit against the Hospital for national origin discrimination.
Two months later, when the doctor’s clinical privileges were reinstated, the Hospital’s board of directors also imposed a proficiency standard requiring interventional cardiologists to perform a minimum of 150 interventional procedures every two years in order for them to retain their hospital privileges. The Hospital applied the new standard retroactively, so any of the four interventional cardiologists that were not currently in compliance would lose their privileges. Doctor Sambasivan was the only person affected by this new standard and, as a result, he lost the privileges that had just been reinstated. The doctor then filed a second lawsuit, claiming that the Hospital had enacted the new standard in retaliation to his initial lawsuit.
To support his claim that the Hospital revoked his privileges based on his Indian heritage, the doctor needed to establish that the Hospital’s discriminatory actions affected his right to make and enforce contracts. The doctor argued that the revocation of his privileges prevented him from contracting with potential new clients who came to him through the Hospital and from further contracting with the Hospital to receive benefits for participating in the on-call schedule.
The Hospital argued that the doctor could not bring his lawsuit because he still had the opportunity to contract with future patients at other hospitals. Additionally, it argued that the loss of the contracting opportunity with the Hospital was only a collateral consequence of losing his privileges, and that the law did not protect such collateral contracting opportunities. Finally, the Hospital argued that the doctor was his own employer and that he lacked the proper employment relationship with the Hospital to bring an employment retaliation claim.
The Court rejected the arguments of the Hospital. First, it agreed with the doctor that revoking privileges would affect the doctor’s right to make and enforce contracts. It explained that the plain language of law prevented discriminatory acts that would deny minorities the same opportunities “enjoyed by white citizens.” The Court stated:
Arguing that a physician may practice his medical specialty at the hospitals that do not discriminate against him is not a defense to a [discrimination] claim, for reasons that were explained by the United States Supreme Court… Although [rules] could [be] enforced without denying [a] general right…the enforcement of those [rules] would nonetheless den[y] [minorities] the same right as is enjoyed by white citizens. That result… [i]s prohibited by [the law]. To suggest otherwise… is to reject the plain meaning of the language.
The Court also rejected the Hospital’s argument that the future contract opportunities with the Hospital were only a collateral result of the doctor’s loss of privileges. It explained that such reasoning was illogical because it fails to recognize that individuals like the doctor can have contracts with parties who intentionally inflict either direct or indirect harm based on racial animus. The fact that the harm was collateral or indirect does not make the racially motivated discrimination any more acceptable.
Additionally, the Court determined that a sufficient relationship existed between the Hospital and the doctor to support a lawsuit for a retaliatory employment action. The Court explained:
The Court [has] refused to construe [the retaliation law] as providing a remedy against any person whatsoever, but has held that it [i]s directed not only at employers but also at entities functionally similar to employers who discriminate by engaging in conduct similar to discharging or expelling a person.
The Court then determined that the Hospital was acting similarly enough to an employer for the law to apply when it contracted the doctor to act as an independent contractor. It also determined that the Hospital’s denial of privileges, which directly affects the ability of physicians to carry on their profession within the hospital, was sufficiently equivalent to discharging or expelling a person.
Ultimately, the Court of Appeals held that it was wrong for the trial court to dismiss the case based on these technicalities. Instead, it ordered that the case continue to trial in order to determine if the Hospital in fact was acting on racial animus.
The Court made the right decision in this case. Several of the Hospital’s actions clearly raised red flags, including evidence that the new proficiency standard only detrimentally affected the Indian doctor. Importantly, this case also expands who may be subject to liability under the retaliation provisions of the Washington Law Against Discrimination. Even though the language of the statute has most frequently been applied to “employers” in the traditional sense, the Court reasoned that the statute also includes entities that are “functionally similar” to employers. While the Hospital in this situation was not a traditional employer (and the doctor not a traditional employee), under the Court’s expansive interpretation of the statutory language, the Hospital was unable to escape liability.
