Holland v. Muscatine Gen. Hosp.

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In Holland v. Muscatine Gen. Hosp., 971 F. Supp. 385 (S.D. Iowa 1997), a federal district court required disclosure of peer review documents despite an assertion of privilege under Iowa law:

As the parties recognize, the state statutory peer review privilege is not conclusive in an action brought in federal court under federal law. Federal Rule of Evidence 501 governs questions of privilege in this court. It is not very definitive. Unless the federal constitution, a federal statute, or court rule is determinative, whether a privilege is recognized is committed to the "principles of the common law" as interpreted by the courts "in light of reason and experience." The recognition of new privileges in federal court thus evolves on a case-by-case basis. See Jaffee v. Redmond, 518 U.S. 1, , 135 L. Ed. 2d 337, 116 S. Ct. 1923, 1927 (1996). The process involves "balancing the public's need for the full development of relevant facts in federal litigation against the countervailing demand for confidentiality in order to achieve the objectives underlying the privilege in issue." 2 J. Weinstein, M. Burger, J. McLaughlin, Weinstein's Evidence P 501[03], at 39-41. The balance does not often favor recognition of a new privilege unless it "promotes sufficiently important interests to outweigh the need for probative evidence." University of Pennsylvania v. EEOC, 493 U.S. 182, 189, 107 L. Ed. 2d 571, 110 S. Ct. 577 (1990) (quoting Trammel v. United States, 445 U.S. 40, 51, 63 L. Ed. 2d 186, 100 S. Ct. 906 (1980)). The starting point in the analysis is always the "fundamental principle that 'the public . . . has a right to every man's evidence.'" Id. (quoting both Trammel, 445 U.S. at 50 and United States v. Bryan, 339 U.S. 323, 331, 94 L. Ed. 884, 70 S. Ct. 724 (1950)). Privileges are disfavored in the law and must be strictly construed. Id.
State law is not irrelevant. The public policy of the states as reflected in their legislative and judicial pronouncements is part of the "reason and experience" which may be drawn on in considering claims of privilege. Jaffee, U.S. at , 116 S. Ct. at 1930. Even when not federally adopted, privileges provided by the law of the forum state should be respected to the extent "this can be accomplished at no substantial cost to federal substantive and procedural policy." Hansen v. Allen Memorial Hosp., 141 F.R.D. 115, 122 (S.D. Iowa 1992) (quoting Memorial Hosp. for McHenry County v. Shadur, 664 F.2d 1058, 1061 (7th Cir. 1981)).
The Court does not believe either that a federal peer review privilege, or Iowa's peer review privilege, should be recognized to prevent disclosure of documents and information which have a close degree of relevance to a hospital's knowledge and investigation of the conduct of physicians which has allegedly resulted in employment discrimination in violation of federal law. Disclosure of documents and information bearing primarily on employment issues does not materially conflict with the fundamental objective of promoting quality health care served by the peer review privilege. The purpose of the peer review privilege is to "encourage an effective review of medical care." Carolan v. Hill, 553 N.W.2d 882, 886 (Iowa 1996). Though the privilege is broad, the policy reasons for it are focused on promoting quality medical care by enabling physicians to consult with and criticize one another without risk of repercussions in order to improve future treatment. See Hutchinson v. Smith Lab., Inc., 392 N.W.2d 139, 140-41 (Iowa 1986). Peer review also assists in weeding out those who are providing substandard care. Id. The Iowa Code provides textual support for this core purpose. "Peer review" is defined as the "evaluation of professional services rendered by a person licensed to practice a profession." Iowa Code § 147.1(8). "Licensee discipline" is defined in Chapter 272C as "any sanction a licensing board may impose upon its licensees for conduct which threatens or denies citizens of this state a high standard of professional or occupational care." Iowa Code § 272C.1(4). Presumably, the term means the same when used in Chapter 147. See Iowa Code § 147.135(2). The use of the peer review process to document and investigate complaints by hospital employees of discrimination or harassment by physicians bears an indirect relationship to the quality of medical care--turmoil in the hospital setting can affect how patients are treated--but the interest in promoting quality medical care is not much served by protecting information of this type from disclosure in an employment discrimination action.

Id. at 388 (footnotes omitted).