1.
Quaere whether, in the circumstances mentioned in
the opinion, a regulation by a municipal hospital board excluding
osteopathic physicians from practicing in the hospital was action
by the state in the sense of the Fourteenth Amendment? P.
273 U. S.
416.
2. A person not claiming to be a citizen of the state, or of the
United States, but having the right under the state law to practice
his profession of osteopathic physician is not deprived of rights
under the federal Constitution -- the Privileges and Immunities
Clause, and the Due Process and Equal Protection clauses of the
Fourteenth Amendment -- by a regulation excluding osteopaths from
practicing in a hospital maintained by the state and its
municipality partly for the instruction of medical students
attending the state university. P.
273 U. S.
416.
3. In Art. XVI, § 31, of the Constitution of Texas, the
limitation that "no preference shall ever be given by law to any
schools of medicine" is directed only to qualifications for
admission to practice. P.
273 U. S.
417.
Affirmed.
Appeal from a decree dismissing for want of equity a bill to
enjoin the respondents from excluding appellant, or other
osteopathic physicians, from practicing their profession in the
hospital maintained by the City of Galveston and from denying
admission to patients who wish to be treated by appellant or other
osteopathic physicians.
Page 273 U. S. 415
MR. JUSTICE STONE delivered the opinion of the Court.
Appellant, a resident of Texas, an osteopathic physician, duly
licensed to practice medicine in the state, brought suit in the
District Court for Southern Texas against the City of Galveston,
the Board of Commissioners of the city, and the members of the
Governing Board of the John Sealy Hospital, maintained by the city,
to enjoin the enforcement of any rule or regulation excluding
appellant or other osteopathic physicians from practicing their
profession in the hospital and denying admission to patients who
wish to be treated by appellant or other osteopathic
physicians.
The bill alleged that the State of Texas, acting through the
Board of Regents of the State University, had leased land to
appellee, the City of Galveston, on which it was maintaining a
municipal hospital in accordance with the provisions of the lease.
The lease, which is annexed to the bill of complaint and made part
of it, stipulates that the state reserves the right of use of the
operating amphitheater, the wards, and grounds of the hospital, by
the faculty of the Medical Department of the State University for
purposes of clinical instruction of medical students attending the
University in Galveston, and reserves also the right for such
purposes to control the treatment of all charity patients. The city
undertakes to permit the use of the facilities of the hospital for
such instruction. The lease further provides that the hospital
shall be managed and controlled by a hospital board, which is given
the exclusive right to prescribe rules and regulations for the
management and conduct of the hospital and to control its internal
government. It is alleged that appellees, the board of managers,
have made regulations excluding appellant and other licensed
osteopathic physicians from practicing in the hospital and
excluding patients who desire to be treated by appellant or other
osteopaths. The bill does not set up diversity of citizenship of
the parties,
Page 273 U. S. 416
and the only ground of jurisdiction alleged is that the suit is
one arising under the Constitution of the United States.
On motion directed to the pleadings, the bill was dismissed for
want of equity. The case comes here on direct appeal. Judicial
Code, § 238, before amended.
The case as presented carries to the point of extreme
attenuation the principle that action by state officials depriving
a person of property is to be deemed the action of the state for
the purpose of determining whether the deprivation is within the
prohibition of the Fourteenth Amendment.
Home Telephone &
Telegraph Co. v. Los Angeles, 227 U.
S. 278;
Raymond v. Chicago Traction Co.,
207 U. S. 20,
207 U. S. 35-36.
Appellant does not point to any law of the state denying his
asserted constitutional right to practice medicine in the John
Sealy Hospital. The bill did not set up that appellees purported to
act under any statute of the state denying such right. Appellant in
fact argues that the state constitution and laws confer upon him
the asserted right which is infringed by the action of the hospital
board.
But, if it be assumed that the question presented is the same as
though the state legislature had enacted the regulation adopted by
the hospital board,
Waterworks Co. v. Owensboro,
200 U. S. 38,
appellant fails to suggest, and we fail to perceive, any
substantial basis for asserting that rights guaranteed to him by
the Fourteenth Amendment have been infringed. The bill does not
allege that appellant is a citizen of the state or of the United
States, and there does not appear to be any substantial basis for
urging that the action of the board abridges any privileges or
immunities of a citizen of the United States. The protection of the
due process clause extends to persons who are noncitizens. But the
only protection claimed here is that of appellant's privilege to
practice his calling. However extensive that protection may be in
other situations, it cannot, we think, be said that all licensed
physicians
Page 273 U. S. 417
have a constitutional right to practice their profession in a
hospital maintained by a state or a political subdivision the use
of which is reserved for purposes of medical instruction. It is not
incumbent on the state to maintain a hospital for the private
practice of medicine.
Compare Heim v. McCall, 239 U.
S. 175.
But it is argued that, if some physicians are admitted to
practice in the hospital, all must be, or there is a denial of the
equal protection of the laws. Even assuming that the arbitrary
exclusion of some physicians would have that legal consequence in
the circumstances of this case, the selection complained of was
based upon a classification not arbitrary or unreasonable on its
face. Under the Texas Constitution and statutes, anyone who shall
"offer to treat any disease or disorder, mental or physical, or any
physical deformity or injury by any system or method, or to effect
cures thereof" is a physician, and may be admitted to practice
within the state. Article XVI, § 31, Texas Constitution; Complete
Tex.Stat. 1920, Arts. 5739, 5741, 5745. We cannot say that a
regulation excluding from the conduct of a hospital the devotees of
some of the numerous systems or methods of treating diseases
authorized to practice in Texas is unreasonable or arbitrary. In
the management of a hospital, quite apart from its use for
educational purposes, some choice in methods of treatment would
seem inevitable, and a selection based upon a classification having
some basis in the exercise of the judgment of the state board whose
action is challenged is not a denial of the equal protection of the
laws.
Compare Collins v. Texas, 223 U.
S. 288;
Watson v. Maryland, 218 U.
S. 173;
Crane v. Johnson, 242 U.
S. 339;
Jacobson v. Massachusetts, 197 U. S.
11.
The validity of the action of the board under the Texas
Constitution is also before us. Article XVI, § 31, of the Texas
Constitution provides:
Page 273 U. S. 418
"The legislature may pass laws prescribing the qualification of
practitioners of medicine in this state, and to punish persons for
malpractice, but no preference shall ever be given by law to any
schools of medicine."
The limitation of the provision is obviously directed to the
qualifications of those to be admitted to the practice of their
profession in the state, and has nothing to do with the
qualifications of those who are to be allowed to practice in a
state hospital or to participate in an educational enterprise
conducted by the state.
Cf. Germany v. State, 62 Tex.Cr.R.
276;
Ex parte Gerino, 143 Cal. 412;
Harris v.
Thomas (Tex.Civ.App.), 217 S.W. 1068.
The action of the board does not violate rights or immunities
guaranteed by either the state or the federal Constitution.
Judgment affirmed.