NORTH BROWARD HOSPITAL DISTRICT ET AL., APPELLANTS,
v.
VON D. MIZELL, APPELLEE

Fla. | 1962-12-21
No. 31742
TERRELL, Acting C. J., THOMAS, THORNAL, O’CONNELL and HOBSON (Ret.), JJ., and WALKER, Circuit Judge, concur.
148 So. 2d 1 Florida Supreme Court (1962) Caution
Cited by 60 cases

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Synopsis

The Florida Supreme Court reversed a lower court decision striking down a statute authorizing a public hospital board to suspend physicians from hospital staff when deemed necessary for patient welfare and hospital interests. The court held that the statutory standard was sufficiently definite to guide the board's discretion and did not violate due process, while remanding for review of procedural fairness issues.


Holding

Section 31 provides an adequately definite standard by authorizing suspension to serve "the welfare and health of patients and the best interests of the hospital," which constitutes notice of required performance standards. The statute is facially valid because discretion granted to hospital boards should be construed as reasonable and judicially reviewable discretion, not arbitrary power, and statutory standards in this context need not be as specific as those required for professional licensing boards.


Key Quotes

“The fundamental requirement controlling such officials, whether engaged in hospital administration or other essentially proprietary activity under governmental auspices, is that their actions, and the enabling legislation under which they act, shall involve the exercise of a reasonable, or judicially reviewable, as opposed to arbitrary discretion, in order to comport with the constitutional concepts of due process and equal protection of the laws.”

Establishes the core constitutional standard that public hospital officials must exercise reasonable and reviewable discretion, not arbitrary power.

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Facts & Procedural History

Dr. Von D. Mizell, a surgeon, was suspended from surgical privileges at North Broward Hospital District effective August 15, 1961, pursuant to board a…

The full statement of facts, procedural history, and disposition for this case are member content.

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Opinion of the Court
DREW, Justice.

DREW, Justice.

This appeal is from a decree of the Circuit Court for Broward County, Florida, adjudging Section 31 of Chapter 27438, Laws of Florida, Special Acts of 1951, to be invalid on its face under due process clauses contained in Section 12, Declaration of Rights, Florida Constitution, F.S.A., and Section 1, 14th Amendment, U. S. Constitution.

Chapter 27438 created the appellant hospital district and provided in Section 31 as follows :

“Realizing that factors other than professional must enter into the qualifications of those who practice medicine and surgery, the Board of Commissioners of said North Broward Hospital District are hereby authorized and empowered to set up rules, and regulations and by-laws for the operation of the hospital and the hospital staff; the Board of Commissioners is authorised to give, grant or revoke licenses and privileges of staff members for practice in and about hospitals maintained wider this Act, so that the welfare and health of patients and the best interests of the hospital may at all times be best served.” 1 (Emphasis supplied.)

The governing board of the hospital district, pursuant to this statutory authorization, adopted by-laws providing among other things in Article VI, Section 3:

“The Board of Commissioners reserves the right to remove any member of the medical staff or to deprive any physician or surgeon of the privileges of the hospital whenever in their sole judgment the good of the hospital or the patients therein may demand it.”

The appellee physician Mizell, by a board resolution of July 19, 1961, was notified of his suspension from the exercise of surgical privileges effective August 15, 1961, *3“for the protection of the health and welfare of patients and in the best interests of the hospitals in this District.” 2 In this proceeding for injunctive and other relief, Mizell stated that this language of the suspension order was intended to mean that plaintiff “was not competent to continue in the exercise of his surgical privileges and that his work was of an inferior and unsatisfactory quality.”

The sole point adjudicated by the decree appealed is that the second sentence of Section 31, Chapter 27438, supra, is invalid and unconstitutional on its face because it “confers an arbitrary power on the board to determine when and how the best interests of the patients and the hospital would be best served.” The quoted by-law was likewise deemed invalid and inoperative. The court upon stipulation refrained from any disposition of other issues raised as to procedural due process in the manner of appellee’s suspension, and as to the merits of the grounds relied upon by the appellant district and board to sustain the suspension.

The court in its decree concludes that the statute is invalid on its face because it fails to provide sufficiently definite standards for the guidance of the board and staff members affected, the opinion treating at length the question of improper delegation of legislative power.3 As above noted, however, the constitutional collisions relied on are with the due process clauses, rather than that portion of our organic law vesting legislative power,4 which is construed to prohibit delegation of the essential legislative function and to permit the exercise of administrative discretion in the performance of quasi-legislative functions only within legislatively prescribed limits. Upon either theory of constitutional invalidity, however, the underlying issues are similar.

As a general rule the conduct of those vested with authority to manage a public hospital, including control of its medical staff, must be “governed by the principles applicable to other public officers.” 5 The fundamental requirement controlling such officials, whether engaged’ in hospital administration or other essentially proprietary activity under governmental auspices, is that their actions, and the enabling legislation under which they act, shall involve the exercise of a reasonable, or judicially reviewable, as opposed to arbitrary discretion,6 in order to comport with the constitutional concepts of due process and equal protection of the laws. Our decisions establish that public hospitals may be authorized to limit and control staff membership by reasonable rules and regulations, a physician having no constitutional “right (per se) to practice in the hospital.”7 Standards of competence established for any given institution may be higher than or different from those required by the state medical licensing board,8 and it is clear that the governing body of a hospital may be authorized, in general terms, *4to suspend medical staff members for infraction of whatever rules it may make for the particular institution. The propriety of such suspensions is tested by judicial review of the reasonableness of the rule in question.

The decree before us suggests, as illustrative of an acceptable rule of action adequate to guide the board, that the statute might provide for exclusions or suspensions for failure to “conform to the accepted standard of practice for the treatment of patients in this district.” The limitation stated in Chapter 27438 is that the power of suspension must be exercised to best serve “the welfare and health of patients and the best interests of the hospital.” Notice of required standards of performance for physicians is, in our opinion, equally definitive under the latter language. Neither expression differs significantly in meaning from that used in other instances to authorize suspension for “unprofessional conduct.”9

It is at least arguable that statutes vesting authority in a hospital board to control medical staff membership are essentially distinguishable from and need contain less specific standards than laws delegating power to a professional or occupational licensing board. Even under decisions relating to the latter situation, however, we are of the opinion that Section 31 of Chapter 27438, supra, adequately states a standard by which the propriety of exclusions or suspensions of physicians from hospital staffs might be measured, and that the court erred in granting injunctive relief on the sole ground that the act showed on its face a fatal insufficiency.

The usual construction of such a delegation of discretionary power is that the discretion to be exercised is a reasonable or judicially reviewable discretion, and the language of the statute, read in context, supports this view. Even the more stringent expression of the by-law in question may under our cases10 be construed, we think, as contemplating a determination and a judicially reviewable determination by the board based on a reasonable relationship to the objective standard of the “welfare and health of patients and the best interests of the hospital,” rather than vesting an arbitrary or uncontrolled power to determine, without regard to demonstrable facts, what shall serve or promote the health and welfare of patients and best interests of the hospital.

Appellee, as shown by his complaint, understood the statutory language incorporated in the suspension order against him as making a charge of professional incompetence. One manner of expression is not materially better than another in this situation to notify the board and staff of standards to be enforced. An exception from the strict requirements of legislative prescription is often recognized in the area of determination of personal fitness.11 *5There is at least equal difficulty in precise definition of professional fitness for staff membership in any given institution or group if, as already adjudicated, public as well as private hospitals are to be allowed latitude in enforcing standards of proficiency above those required for licensing. Detailed description of prohibited conduct is concededly impossible, perhaps even undesirable in view of rapidly shifting standards of medical excellence and the fact that a human life may be and quite often is involved in the ultimate decision of the board.

The decree is reversed and the cause remanded for disposition of the independent issues raised below' as to sufficiency of procedural due process accorded by the board’s rules and actions, and as to proof of facts reasonably requiring suspension in the interest of patient health and welfare.

It is so ordered.

TERRELL, Acting C. J., THOMAS, THORNAL, O’CONNELL and HOBSON (Ret.), JJ., and WALKER, Circuit Judge, concur.


Cases With Similar Vibessemantic neighbors from the corpus


Citator

Cited By (31 total)

  • In the Interest of D.P. v. State, 597 So. 2d 952 (Fla. 1st DCA 1992)
    …of the public, it is not essential that a specific prescribed standard be expressly stated in the legislation. In such situations the courts will infer that the standard of reasonableness is to be applied. North Broward Hospital District v. Mizell, 148 So. 2d 1, 4, n. 11 (Fla.1962) (quoting 1 Am.Jur.2d Administrative Law § 116); see also Department of Business [*955] Regulation, Division of Alcoholic Beverages and Tobacco v. Jones, 474 So. 2d 359 (Fla. 1st DCA 1985); Florida Waterworks Assoc. v. Florida Pu…
    1 / 2
  • …. Younan, 159 Fla. 226, 31 So. 2d 387 (1947). But the discretion that is granted to such an agency must be sufficiently governed by legislative standards as to constitute a judicially reviewable discretion. North Broward Hospital District v. Mizell, 148 So. 2d 1 (Fla.1962); Hutchins v. Mayo, 143 Fla. 707, 197 So. 495 (1940). The district court relied on the case of Husband v. Cassel, 130 So. 2d 69 (Fla.1961). In that case, this Court had for consideration the statute governing the certification of psycholo…
  • Solimena v. State, 402 So. 2d 1240 (Fla. 3d DCA 1981)
    …with police power, the legislature may find it impractical to express a comprehensive standard. In that circumstance, a specific standard need not be expressed and the standard of reasonableness is applied. North Broward Hospital District v. Mizell, 148 So. 2d 1 (Fla.1962); Brewer v. Insurance Commissioner & Treasurer, supra. Also excepted from the guideline requirement are occupations which are practiced by privilege rather than by right and which are potentially injurious to the public welfare. These sta…
    1 / 2

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