2012 Decision of the Health Professions Appeal and Review Board

Dr. Thannikkotu, a cardiac surgeon with 11 years experience in the United States, was appointed as a surgical assistant at the Trillium Health Centre. He subsequently asked the hospital to change his medical staff appointment from “Courtesy” staff to “Active” staff. He argued that he met the criteria for “Active” staff, since his five years of service as a surgical assistant should be considered in lieu of the requirement of two years probation as a Cardiac “Associate” staff. The hospital’s Board of Directors denied his request. It held that when he joined the hospital, he knew his role was limited to that of a surgical assistant who could not perform surgery, and would not have an independent practice. He appealed. Among other things, he complained that the hospital had not treated him fairly.

On appeal, the Health Professions Appeal and Review Board (“HPARB”) agreed with the hospital’s decision, but found that the hospital had failed to meet its duty of procedural fairness to the physician. It found that the hospital’s handling of the case was less than transparent or fair, and that this “tainted” the application process.

However, the HPARB exercised its powers to consider the matter de novo, and ultimately reached the same conclusion as the hospital did. It found that he did not meet the criteria for “Active” staff privileges, and could not leapfrog the probationary period of “Associate” staff status: “A probationary period is intended to allow the Hospital’s medical leaders the opportunity to assess, in a supervised setting, an associate’s abilities.” The HPARB emphasized that the hospital has a fiduciary duty to ensure it effectively credentials physicians: “Underlying this duty is the notion that patient safety must be of paramount concern to the Board of the Hospital when making a decision regarding physician applications for appointment”.