Antitrust Scrutiny of the Medical Staff Plan

Advances in medical technology over the past 50 years have made access to a hospital, its medical staff, and the support facilities and equipment it provides essential for many physicians. Until recently it was not difficult for a qualified physician to obtain staff privileges. In recent years, however, an increasing number of hospital governing boards across the United States have begun to design and implement what are known as "medical staff plans." The often-stated purpose of these plans is to alleviate hospital overcrowding and unstructured staff growth by applying an ordered approach to future medical staff growth, taking into account long and short-term hospital needs. Although these are legitimate goals, staff plans also provide a method by which the hospital's incumbent medical staff may curtail entry of new physician applicants into the area, and thereby decrease the threat of competition. Medical staff plans may constitute a new method of employing anticompetitive tactics which are carefully screened by procompetitive justifications. Because more and more hospitals are "closing" their staffs and imposing barriers to new applicants, an increasing number of disappointed applicants are filing antitrust actions.