There are a few hospitals in North Carolina that have ex-officio positions on their governing bodies for county commissioners. This is grounded in the historic (and in some cases, current) connections between those hospitals and local government. In Cumberland County, all county commissioners are ex-officio members of the governing body of Cape Fear Valley Health System. Recently, when a county commissioner resigned mid-term, the local party officials appointed a replacement commissioner.

The new commissioner is a lawyer who works at a plaintiffs’ firm that has represented numerous clients against the hospital and local physicians. Having a lawyer, who works at a medical malpractice plaintiffs’ firm involved in all of the health system’s credentialing, peer review, and quality management activities, caused grave concerns among the medical staff and hospital administration. We believe this is the first time a lawyer practicing in a medical malpractice plaintiffs’ firm has been placed on a hospital’s governing body.

The medical staff held an emergency meeting to address the issue. At that meeting, several actions were taken to ensure the obvious conflict of interest was properly addressed. Among them, the medical staff decided to retain counsel to ensure that any confidentiality agreements or conflict of interest policies formulated to address this situation provided adequate protection for the individual physicians on the medical staff. David Sousa, general counsel for Medical Mutual Insurance Company, and Stephen Keene, general counsel for the NC Medical Society, attended the medical staff meeting, as well. Mr. Sousa announced at the meeting that Medical Mutual would assist in indentifying counsel with appropriate expertise and cover the costs of the representation. Dan McLamb, of Yates McLamb & Weyher in Raleigh, was hired to represent the medical staff in the negotiations.

Ultimately the commissioner signed a confidentiality agreement and conflict of interest policy  that, among other things, requires the commissioner to recuse himself from all performance improvement, quality assessment, peer review and liability claims during his tenure. Earlier this week, the new commissioner lost in a four-way primary for the Democratic nomination for the commission seat.

The work done by the medical staff and their counsel provides excellent guidance to medical staffs that confront this issue in the future. The NCMS appreciates the leadership and prompt action of Medical Mutual Insurance Company to assist the medical staff with this issue.

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