Patrick v. Burget

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In Patrick v. Burget, 486 U.S. 94 (1988), the U.S. Supreme Court reinstated a judgment won by a physician for been victimized by bad faith or sham peer review. The Court reversed a decision by the Ninth Circuit which had found that state action doctrine protected physicians who participated in peer review.

The Court in Patrick held that Oregon did not satisfy the active supervision prong of state action doctrine because the state did not exercise "ultimate control" over the challenged anticompetitive conduct.

The Court held that no state agency or official provided the requisite supervision. The Court noted that Oregon's statutory scheme merely authorized state agencies to review the termination procedures and to regulate the licensing of physicians.[1] Such review was insufficient for immunity because the statute did not authorize the agencies to review the peer review board's decisions.

The Court noted that Oregon's judicial system did not actively supervise the board's decisions. The Court found that the Oregon courts only ensured that (1) the peer review board followed a reasonable procedure and that (2) sufficient evidence existed to find that a terminated physician's conduct threatened such physician's patients. This review "falls short of satisfying the active supervision requirement."[2]

Congress enacted HCQIA to establish the immunity denied in this case.


  1. 108 S. Ct. at 1664.
  2. 108 S. Ct. at 1664-65.