As a medical doctor with over 15 years of experience, I have witnessed firsthand the complex dynamics between healthcare providers, researchers, and administrators. The recent legal dispute between Dr. Negin Behazin and Dignity Health has brought many of these issues into sharp focus.
In my career, I have treated patients at both large hospital systems like Dignity and smaller specialized clinics led by entrepreneurial doctors like Dr. Behazin. Both play an invaluable role in our healthcare ecosystem. However, conflicts inevitably arise when profits, progress, and patient care collide.
In this post, I will analyze the Negin Behazin vs Dignity Health case in a balanced, objective manner. As a neutral third-party physician, I aim to highlight the perspective of both sides, provide relevant context on the healthcare industry, and share my insights from medical practice. My goal is to educate and inform, not advocate for one side over the other.
The Story Behind the Headlines
In 2018, Dr. Negin Behazin sued Dignity Health for allegedly denying her medical staff privileges on the basis of gender, race, and national origin discrimination. She had recently moved to California after completing her Ph.D. in Biomedical Engineering at UCLA and sought to practice neuromodulation procedures at Dignity Health’s facilities.
Dr. Behazin claimed that despite being extremely qualified – including being named to the Forbes “30 Under 30” in Healthcare list – she was denied privileges by Dignity’s credentialing committee. She alleged that male, non-minority applicants with inferior credentials were granted privileges over her.
Dignity Health denied these allegations and stated that credentialing decisions were made based on merit and hospital needs. They claimed no discrimination occurred. After years of legal proceedings, the parties reached a confidential settlement in 2022.
Who is Dr. Negin Behazin?
To understand this case, we must first understand who Dr. Behazin is. She is an ambitious, talented young physician making waves in the emerging field of neuromodulation.
| Category | Information |
|---|---|
| Education | PhD in Biomedical Engineering, UCLA |
| Awards | Forbes “30 Under 30” in Healthcare |
| Company | Founder & CEO of IntuiTap Medical |
| Research Focus | Novel neuromodulation treatments for epilepsy, Parkinson’s, chronic pain |
Dr. Behazin graduated at the top of her class from UCLA with a PhD focused on developing cutting-edge neural stimulation devices. She has pioneered groundbreaking technologies such as a smart deep brain stimulation system that automatically adjusts stimulation based on a patient’s symptoms and response.
Her trailblazing work has led to prestigious honors like being named to the Forbes “30 Under 30” list recognizing the most talented young entrepreneurs and leaders. She founded her startup, IntuiTap Medical, to commercialize her ideas and make them accessible to patients worldwide.
Despite her youth, she is considered a rising star in neurotechnology and a foremost expert on emerging neuromodulation therapies. However, as a young Iranian-American woman, she had to work doubly hard to achieve this level of success in a field still dominated by older white men.
What is Dignity Health?
Dignity Health, now part of Common Spirit Health, is a large Catholic non-profit health system operating hospitals across the Western United States. With over 150 facilities, it is the fifth-largest hospital provider in the nation.
| Metric | Value |
|---|---|
| Hospitals | Over 150 |
| States with Facilities | CA, NV, AZ |
| Annual Discharges | Over 765,000 |
| Employees | Over 60,000 |
| Annual Revenue | $13 billion |
Dignity Health offers a wide range of services, from state-of-the-art specialty care to community-based primary care clinics. It prides itself on its values of compassion, inclusion, integrity, excellence, and collaboration.
As a non-profit, Dignity Health’s mission is to provide high-quality, affordable care to all people regardless of background, not maximize profits. Approximately $2 billion per year is spent on charity care and unpaid costs of public programs like Medicaid.
However, as a huge system, Dignity faces challenges in consistency and coordination across its vast network. Standardizing policies and practices across so many hospitals and clinics has proven difficult.
Credentialing Process
To legally treat patients at any hospital, physicians must be granted privileges through an extensive credentialing process. This involves having their education, training, experience, malpractice history, and other factors vetted by the hospital’s medical staff.
This is done to ensure only competent, qualified doctors are allowed to practice and is crucial for patient safety. While reasonable in theory, credentialing has also been misused to exclude providers for unfair reasons.
At Dignity Health, credentialing is handled by each hospital’s medical staff credentialing committee. They make subjective determinations if a physician’s qualifications sufficiently match the hospital’s needs and standards. There is little oversight or accountability for these opaque decisions.
Account From Each Side
Here is a summary of the perspectives from Dr. Behazin and Dignity Health based on public legal filings and statements:
| Dr. Negin Behazin’s Account | Dignity Health’s Account |
|---|---|
| – Extremely qualified credentials unfairly denied | – Credential decisions based on merit |
| – Similarly, qualified male peers given privileges | – Hospital needs factored in decisions |
| – Discriminated against as a young Iranian woman | – No evidence of gender/race discrimination |
| – Long fight for privileges delayed care innovations | – Care innovations not guaranteed privileges |
| – Merit should determine credentialing, not discrimination | – Credential committees have discretion |
Dr. Behazin states that despite being clearly qualified for privileges, she was denied for discriminatory reasons. She alleges that the “old boys club” did not take her merits seriously as a young Middle Eastern woman.
Meanwhile, Dignity Health contends it did nothing wrong and based decisions purely on physician qualifications matching hospital credentialing standards and needs. It states no evidence supported any gender or racial discrimination.
Hospital Credentialing Controversies
Unfortunately, allegations of unfair or biased hospital credentialing are commonplace in modern healthcare. A few recent examples:
- In 2020, an emergency physician sued a Michigan hospital for allegedly denying him privileges because he criticized their pandemic response.
- In 2022, the Medical Board of California accused a hospital of restricting privileges to certain spinal procedures to keep out competing doctors.
- In 2021, the DOJ sued a West Virginia hospital for allegedly excluding out-of-state doctors to reduce competition.
These cases highlight how credentials can be weaponized to block doctors that hospitals view as problematic or competitive threats. However, enforcing discrimination laws against hospitals’ credentialing decisions remains challenging. Hospitals possess enormous discretion and little accountability.
Perspectives From Both Sides Have Merit
Upon deep examination, there are convincing perspectives and arguments from both Dr. Behazin and Dignity Health’s sides.
| Dr. Behazin’s Perspective | Dignity Health’s Perspective |
|---|---|
| Credentialing biases against women & minorities are real | Doctors often incorrectly blame credentials for rejection |
| She deserved privileges based on achievements | Every qualified doctor can’t get privileges |
| Hospitals want “obedient” not “loud” doctors | Credentials should align with hospital standards/needs |
| Merit-based credentialing is ideal | Committees require latitude in decisions |
Dr. Behazin highlights the very real biases that women and minority physicians face in credentialing and beyond.
However, Dignity also makes reasonable points. In a large hospital system, not every qualified physician can be accommodated. Factors like specific hospital needs must be weighed beyond just credentials when making determinations. Credentials committees require some discretion and latitude in order to make nuanced decisions.
The Aftermath
After years of contentious legal proceedings, the parties agreed to a confidential settlement in 2022. The terms were not disclosed publicly, so the exact outcome remains unclear.
Some health law experts speculate Dignity Health paid Dr. Behazin a substantial financial settlement in exchange for permanently dropping the lawsuit. This would allow them to avoid a drawn-out trial and the public relations headaches surrounding it.
Neither party admitted wrongdoing or fault as part of the agreement. Dr. Behazin has not publicly commented much on the dispute since the settlement.
Meanwhile, Dignity Health maintains that it did nothing improper or discriminatory in its handling of Dr. Behazin’s credentialing application.
Impact on Healthcare
This high-profile case has stimulated much debate on the issues of discrimination, bias, and fair treatment of physicians within the medical profession.
It prompted physician groups like the California Medical Association to reexamine credentialing policies at hospitals across the state. Pressure has mounted to make the credentialing process more transparent, objective, and merit-based.
However, significant reform remains unlikely. Hospitals are unwilling to relinquish control over a domain so vital to their institutions.
Lessons Learned from This Epic Battle
Reflecting on this complex issue as an independent physician, I believe there are important lessons for doctors and healthcare administrators:
- Credentialing controversies point to the real biases women and minority physicians face daily. Subtle discrimination still permeates medicine.
- Hospitals must ensure credentialing is merit-based and applied equitably. However, some discretion and subjectivity are reasonable.
- Young innovators like Dr. Behazin, who challenge the status quo, often face resistance from established players.
- There are no perfect plaintiffs or defendants. Each side has valid concerns.
- More transparency and fairness in hospital credentialing is needed. But progress will be gradual.
Final Thoughts
It is unlikely any sweeping reforms will immediately follow cases like Dr. Behazin’s. Healthcare evolves slowly. Many complex competing interests exist.
However, this case has ignited vital discussion and prompted reflection on underlying problems in our healthcare system that must be addressed over time.
I am hopeful that a new generation of diverse, progressive physicians like Dr. Behazin can gradually shift medicine’s culture to be more inclusive and equitable. It will be an uphill battle, but one worth fighting.
We must continue to push medical institutions to live up to their espoused ideals of compassionate, unbiased care. And we must advocate for innovators and outliers who dare to challenge the status quo. It is never easy being a disruptor in such an entrenched industry.
If cases like this nudge us a little further in the right direction of positive change, then some good has come from the controversy. Medicine only improves when flaws are brought to light.
As always, I welcome feedback from readers on this complex case and the broader issues it raises. Our healthcare system has far to go, but progress starts with having open, honest dialogue between all stakeholders.