Cover Story

Can you speak your mind and keep your job?

The tales of two St. Louis doctors illustrate why you can't take freedom of speech for granted when you're somebody's employee.

By Robert Lowes
Midwest Editor

St. Louis ob/gyn David Gearhart is no stranger to the news media. When he chaired the state chapter of his ob/gyn society, local reporters routinely rang him up for quotes on women's health issues. "Medical expert says such-and-such." Normally, it's good press.

In 1998, however, a television interview cost Gearhart his job at St. Luke's Hospital.

Gearhart thought he was merely standing up for his patients. He claimed that staffing changes in the hospital's obstetrics department had resulted in less-qualified nurses—even non-nurses—helping doctors perform cesarean sections. The hospital contends that Gearhart sullied its reputation by falsely implying St. Luke's was a dangerous place to have a baby.

So what happened to Gearhart's constitutional right to free speech? Wake up to one of the first lessons about working for somebody else. The First Amendment prohibits only the government from gagging you. Employers have more leeway to police what you say.

On one level, this is understandable. "Every employer has the right to an employee who doesn't disparage him," says health care attorney Daniel Bernick with The Health Care Group in Plymouth Meeting, PA.

On the other hand, there are laws that prevent employers from unduly silencing employees. Those who engage in collective bargaining—even if they're not technically unionized—can publicly criticize their employers within limits and get away with it. Whistle-blowers who expose malfeasance are shielded, as well.

A jury may decide whether Gearhart is a whistle-blower who should have kept his job. In a lawsuit scheduled to reach court in June, Gearhart argues that the hospital wrongfully fired him after he'd brought a potential health hazard to the public's attention.

Cases like Gearhart's may become more common as doctors increasingly choose to be somebody else's employee. Just a few miles away, at St. John's Mercy Medical Center in St. Louis, internist Farrin Manian almost lost his part-time job over a letter to the local newspaper about the evils of corporate medicine. The hospital later rescinded its decision not to renew his contract, but could have let him go if it had really wanted to play hardball.