Friday, December 29, 2006
C.A. Affirms Dismissal of UCLA Primary Care Doctor
Court Rejects Claim Physician Was Fired for Advocating for Patients
By a MetNews Staff Writer
This district’s Court of Appeal upheld the dismissal of a UCLA student-services doctor yesterday, rejecting the claim he was fired for his advocacy of medically appropriate health care.
Dr. George Sarka was employed for 14 years as a primary care physician at UCLA’s student health services’ Arthur Ashe Student Health and Wellness Center. At SHS, students see primary care physicians who treat them directly, or when appropriate, refer them to other health care professionals for more specialized treatment.
Beginning in February 2001 Sarka began reporting to Assistant Vice Chancellor Edward Wiesmeier, M.D. In August 2002, the university dismissed Sarka for refusing to modify his approach to patient care to make it more consistent with his colleagues in being less wasteful of resources by relying less on diagnostic testing and more on ‘optimal clinical judgment.’”
Sarka filed a grievance alleging that his termination was, in relevant part, “clearly retaliatory for advocating appropriate patient care . . . .” The administrative hearing officer upheld the termination, and Sarka filed a petition for administrative mandate in Los Angeles Superior Court.
Judge David P. Yaffe denied the petition, ruling that Sarka “was not fired for [incompetence, discipline, or] . . . for advocating for medically appropriate healthcare for the students of UCLA [pursuant to] section 2056(a) . . . . Petitioner was fired for insubordination.”
Yaffe explained that as a subordinate employee, Sarka had the duty to obey orders given by his superior as long as those orders fell within the scope of his authority and were not improper.
Sarka appealed, contending that Yaffe failed to consider Business and Professions Code Sec. 2056, which declares it a violation of public policy for employers to penalize physicians “principally for advocating for medically appropriate health care.”
Sarka argued that Yaffe’s statement that the court had “neither the expertise nor the duty to decide which of the two physicians [Dr. Sarka or Dr. Wiesmeier] is right.” showed that Yaffe improperly refused to apply Sec. 2056.
Justice Richard D. Aldrich, writing for Div. Three, disagreed, saying:
“Looking at the statute, its application requires expert testimony about whether a physician’s advocacy was ‘medically appropriate.’
“The University substantiated its position with medical literature and references to generally accepted standards of practice in the community of primary health care physicians at SHS, at student health centers at the other University of California campuses, and at “benchmark universities.… Thus, the University’s evidence established that the University’s policies were medically appropriate for student health care at large university campuses and the reason Dr. Sarka’s failure to abide by the practice requirements was harmful to SHS and students.”
“By contrast, Dr. Sarka presented evidence that his performance did not fall below the standard of care. But this case is not about negligence or malpractice.
“What was relevant to Business and Professions Code section 2056 in this case was whether, in refusing to rely more on his own medical and clinical judgment and less on diagnostic testing, Dr. Sarka was ‘advocating for medically appropriate health care.’”
The justice concluded:
“Toward that end, Dr. Sarka was obligated to demonstrate that his advocacy was ‘medically appropriate’ for primary care physicians in a large university’s student health service. This he did not do.”
Justices H. Walter Croskey and Patti S. Kitching concurred in the judgment.
The case is Sarka v. The Regents of the University of California, B181753
Copyright 2006, Metropolitan News Company