Opinion ID: 1168689
Heading Depth: 1
Heading Rank: 6

Heading: The summary suspension of Dr. Ritter damaged his ability to practice medicine and put a stigma upon his name and reputation, giving rise to a constitutionally protected liberty interest.

Text: The Fourteenth Amendment protects citizens from state deprivations of liberty interests without due process of law. The Roth court has given some meaning to the liberty concept, enumerating two circumstances which would trigger a person's liberty interests. First, where an employee has been discharged (or his contract not renewed), by reason of charges that might seriously damage his standing and associations in his community ... for example, that he had been guilty of dishonesty, or immorality.... For [w]here a person's good name, reputation, honor, or integrity is at stake because of what the government is doing to him, notice and an opportunity to be heard are essential. Wisconsin v. Constantineau, 400 U.S. 433, 437. (Citations omitted.) Roth, at 573. Second, through its decision not to rehire the employee, the State imposed on him a stigma or other disability that foreclosed his freedom to take advantage of other employment opportunities ... for example, ... regulations to bar the respondent from all other public employment in state universities. Had it done so, this, again, would be a different case. For [t]o be deprived not only of present government employment but of future opportunity for it certainly is no small injury.... Joint Anti-Fascist Refugee Committee v. McGrath [341 U.S. 123], at 185 (Jackson, J., concurring). Roth, at 573-74. We believe that Ritter's situation epitomizes the different case to which the Roth court referred. The news of Ritter's suspension was reported in the local and regional press. The impact of the summary suspension was so great that at the age of 53 Dr. Ritter literally found himself unable to practice medicine in the Central Washington area. The trial court concluded: The Hospital District's summary suspension of Dr. Ritter's clinical appointment to the medical staff of the Ritzville Memorial Hospital, without a prior hearing, deprived him of his liberty to pursue his chosen profession and imposed upon Dr. Ritter a stigma that called into question his good name, honor and integrity and effectively foreclosed Dr. Ritter's freedom to engage in the general practice of medicine in his practice area. Such deprivation of Dr. Ritter's good name, honor and integrity, without a prior hearing or opportunity to be heard, constituted state action by a state municipality that deprived him of his liberty interests in violation of the due process clause of the 14th Amendment of the United States Constitution. The court's conclusion rested on abundant findings of fact, all of which are supported by substantial evidence. Other courts have found that curtailment of a doctor's staff privileges may trigger due process protection based on the doctor's liberty interest. Harm to a doctor's reputation was a factor which the court considered in Christhilf v. Annapolis Emergency Hosp. Ass'n, 496 F.2d 174 (4th Cir.1974) holding that a doctor's privileges in a specific medical area could not be limited without affording him procedural due process. In Meredith v. Allen County War Memorial Hosp. Comm'n, 397 F.2d 33 (6th Cir.1968), five physicians wrote letters to the authorities complaining of certain acts of the plaintiff/doctor and recommending that he not be appointed to the staff. The complaints did not question his professional ability, but were based on matters such as general uncooperativeness, refusal to handle emergency cases, and dismissal from various medical associations. Meredith, at 34. In holding that due process placed limitations on the physician's exclusion from practice, the court noted that the stigma ... would result from a dismissal on the grounds mentioned in the letters of defendant physicians ... [and that t]he charges of uncooperativeness and the intimations of unethical behavior in the instant case reflect adversely on plaintiff's reputation ... Meredith, at 36. The charges leveled against Ritter  non-cooperation, failure to adhere to Hospital rules and regulations, and performance of surgery without a qualified assistant  are similar to the charges brought against the doctor in Meredith and due process requires the same limits on the procedure employed in excluding him from practice. The second test of determining the presence of a liberty interest articulated in Roth  foreclosure from employment  is also present in Ritter's case. The findings of fact show that immediately after his suspension Dr. Ritter lost 25 percent of his patients, necessitating staff layoffs at his clinic. Additionally, Ritter lost his courtesy privileges at Odessa Hospital, and his application for staff privileges at Moses Lake Good Samaritan Hospital was put on hold until they received additional information on the Adams County suspension. Ritter's subsequent attempts to enroll in the United States Navy and the United States Air Force Physician Corps were similarly rebuffed for the same reason. In short, the summary suspension effectively deprived Ritter of the pursuit of his medical practice. He was forced to take low paying employment as a resident in training at the University of Southern California Medical School. Other courts have considered the degree to which a doctor has been foreclosed from practice by state action. The more severe the deprivation, the more likely that the physician has a right to procedural due process. Christhilf v. Annapolis Emergency Hosp. Ass'n, supra at 178. The trial court's findings reflect that a mortal blow was struck to Ritter's Ritzville practice. His liberty interests were triggered by both the derogation of his good name and reputation in the community and among his peers, and the preclusion of his right to practice at the Ritzville Memorial Hospital.