On January 5, 2015, the U.S. District Court for the Northern District of Texas dismissed claims brought by a physician under the Americans with Disabilities Act (ADA) against a hospital system. In Luedecke v. Tenet Healthcare Corp., Dr. Robert Luedecke claimed that the hospital system violated the ADA by retaliating against him and by refusing to grant his request for accommodation.
Dr. Luedecke is an anesthesiologist who had privileges in the system’s San Antonio hospitals. As a member of the hospitals’ medical staffs, Dr. Luedecke provided anesthesia services when requested by surgeons, and he was required to serve on the emergency room on-call list.
Beginning in 2010, Dr. Luedecke began requesting to be removed from on-call lists because he suffered from a disc disease of the neck. He indicated that this disease caused chronic pain and that his doctor had prescribed certain restrictions and medications that necessitated his removal from the on-call lists. His initial request was denied. Thereafter, Dr. Luedecke resubmitted his request to be excused from on-call duties on three separate occasions, but the hospital system denied each request.
When Dr. Luedecke submitted his second request, he also submitted a letter from his treating physician. The letter indicated that the medications prescribed to Dr. Luedecke would not keep him from working, but that his impairments should be sufficient justification to excuse him from on-call duties. To support his third request, Dr. Luedecke submitted a letter from his rehabilitation doctor. This letter stated: “With the nature of on call work being inherently unpredictable, it is my opinion that [Dr. Luedecke] is at risk of damaging his own health by performing such work.”
When Dr. Luedecke submitted a fourth request to be removed from on-call duties, the hospital system required him to obtain a physical examination from his treating physician and furnish the examination results to the system. The hospital system’s Medical Board reviewed the results of the physical examination during a meeting that Dr. Luedecke was not permitted to attend. Members of the Medical Board unanimously agreed to deny Dr. Luedecke’s request. The Medical Board held a subsequent meeting to reconsider Dr. Luedecke’s request. Dr. Luedecke was permitted to attend this meeting and to make a statement before the Board. Nevertheless, the Medical Board upheld its decision.
Following the Medical Board’s denial of Dr. Luedecke’s fourth request, the hospital system entered into a contract with a new anesthesia provider. As a result, the hospital required Dr. Luedecke’s services at only one of the system’s hospitals. However, this hospital would eventually be covered by the new anesthesia provider as well.
Dr. Luedecke filed a charge of discrimination with the District Office of the Equal Employment Opportunity Commission (EEOC), and the EEOC issued a “Notice of Right to Sue.” Dr. Luedecke then filed a suit against the hospital system in the U.S. District Court for the Northern District of Texas.
Under the ADA, an employer may not “discriminate against a qualified individual on the basis of disability.” Employer discrimination includes failure to provide “reasonable accommodations” for an employee who has a disability. The ADA defines a disability as “(A) a physical or mental impairment that substantially limits one or more major life activities of [an] individual; (B) a record of such impairment; or (C) being regarded as having such an impairment.”
The hospital system argued that Dr. Luedecke failed to allege that he suffered from a disability that limited a major life activity, such as working. Dr. Luedecke claimed that his disc disease “limits his major life activity of work as well as non- work related activity.” To support this conclusion, Dr. Luedecke referenced the letters from his physicians.
Upon reviewing the letter from Dr. Luedecke’s treating physician, the court concluded: “This letter does not indicate that [Dr. Luedecke’s] impairments prevent him from working; to the contrary; it states that [Dr. Luedecke] can still work, despite the medications prescribed to treat his ailment.” The court concluded that the letter from Dr. Luedecke’s rehabilitation doctor offered “a speculation or fear of future ailment” but did not indicate that Dr. Luedecke “suffered from a disability at the time of his request for accommodation.”
Dr. Luedecke alleged that the hospital system regarded him as having a disability. However, based on Dr. Luedecke’s statement of facts, the court disagreed. “The Complaint discusses at length [the hospital system’s] skepticism toward [Dr. Luedecke’s] allegation that an ailment prevented him from being scheduled for on-call duty.” The court dismissed Dr. Luedecke’s claim of discrimination because he failed to allege sufficient facts to show that he suffered from a disability.
In addition to his claim that the hospital system discriminated against him, Dr. Luedecke alleged that the hospital system retaliated against him. Under the ADA, a plaintiff claiming retaliation must show that “(1) he engaged in a protected activity; (2) he suffered an adverse employment action; and (3) there was a causal connection between the protected act and the adverse action.” According to Dr. Luedecke, the denials of his requests for accommodation and the hospital system’s requirement that he submit to a physical examination constituted adverse employment actions. The court disagreed. Furthermore, the court found that the system’s decision to enter into a contract with a new anesthesia provider did not constitute an adverse employment action under the ADA. According to the court, the system’s decision to contract with a new anesthesia provider “was not a narrow employment decision that only affected [Dr. Luedecke], . . . it was instead a structural change that affected all anesthesia services” in the system. Because Dr. Luedecke failed to assert sufficient facts showing that he suffered from an adverse employment action, the court dismissed his claim of retaliation. However, the court granted Dr. Luedecke thirty days to overcome the deficiencies in his pleadings.
The court’s treatment of the system’s decision to enter into a contract with a new anesthesia provider is noteworthy for physicians and hospitals. Even though this decision reduced the need for Dr. Luedecke’s services in the system’s hospitals, the court concluded that the decision did not constitute an adverse employment action under the ADA. To further justify a hospital’s ability to make such decisions, medical staff bylaws should outline the hospital’s right to enter into exclusive contracts and the effect exclusive contracts will have on applicants to and members of the medical staff.