In Miller v Eisenhower, what was required for denial of a physician's application based on disruptive behavior to be upheld?

• A. Disruptive behavior alone is enough to deny any applicant.
• B. Disruptive behavior must pose a real danger to quality of medical care.
• C. Any medical staff denial is unethical.
• D. There must be documented patient complaints.

Answer: (B)

Patient safety and the impact on care quality drive whether a denial based on disruptive behavior can be upheld. In Miller v Eisenhower, the controlling idea is that denying a physician’s application for disruptive conduct is permissible only if there is credible evidence that the behavior poses a real danger to the quality of medical care. It’s not enough to show the physician is troublesome; the behavior must translate into a genuine risk to patient safety or to the standard of care.

This matters because credentialing decisions must be based on risk to patients, with substantial evidence linking the conduct to potential harm or decreased care quality, rather than on personality conflicts alone. Documents like patient complaints can support the case, but they aren’t the sole requirement; what matters is the demonstrated threat to patient safety or care quality.

So, the best answer is that disruptive behavior must pose a real danger to quality of medical care.