Alexander

I. BACKGROUND

A. Nonrenewal of Alexander’s Privileges Alexander is a board-certified specialist in internal medicine. In June 2017, the Department, which runs a system of ambulatory care clinics in Los Angeles County, granted Alexander privileges to practice at its Martin Luther King, Jr. Outpatient Center (MLK). Newly hired physicians at Department clinics are initially granted a six-month provisional privilege; if a physician successfully completes his or her probationary period, they are granted a “full active privilege” which must be renewed every two years. In her first “physician performance evaluation,” which covered the period from June 1, 2017, through December 1, 2017, Alexander met or exceeded expectations on all evaluative criteria. One area in which her performance exceeded expectations was “medical record maintenance.” In her second evaluation, which covered the period from August 1, 2017, to July 31, 2018, her

2 reviewer found she met expectations with regard to all performance criteria, including maintenance of medical records. In the summer of 2018, Alexander took leave from July 16 to August 3 because she felt overwhelmed by work and her medical…