Okay, it wasn’t really Rip Van Winkle.  Rip slept for only twenty years.  It was Dr. Legrand Belnap who sued a Salt Lake City hospital and its medical executive committee members.  But from the looks of his pleadings, he’s been asleep for nearly thirty years—since before enactment of the Health Care Quality Improvement Act of 1986 (HCQIA).

Dr. Belnap applied for reappointment at the hospital.  The medical executive committee recommended denial.  That entitled him to a fair hearing under the medical staff bylaws.  Rather than attend the hearing, Dr. Belnap sued in federal court to enjoin the hearing.  And while he was at it, he sued the hospital and some of its doctors for antitrust conspiracy, defamation, and generally “outrageous and intolerable” conduct.

On Wednesday the court denied the injunction, citing—you guessed it—HCQIA, which requires a physician to exhaust professional peer review proceedings before going to court.  The court also noted that HCQIA insulates peer review participants from liability if they follow the requirements of the peer review process.

The case is a good illustration of precisely why Congress enacted HCQIA in the first place.  Before its enactment, hospitals and physicians were severely hampered in their efforts to conduct effective peer review.  First, the physician under the review could run to court to stop or at least hinder the process.  Second, fear of antitrust litigation and liability was omnipresent and chilling.  After all, the subject physician’s fellow medical staff members were likely to include professional competitors.  And antitrust liability carries treble damage sanctions.

So we should probably be grateful to Dr. Van Winkle—oops, I mean Belnap—for the trip down memory lane and the history lesson.

The case is Belnap v. Iasis Healthcare et al., Case No. 2:14-cv-00086 (D. Utah, Feb. 4).