with whom JOHN R. BROWN, Circuit Judge joins, dissenting:
Curtis W. Caine, Jr., M.D. sued M.D. Hardy, M.D. and others on the grounds that the defendants terminated his hospital privileges out of a personal vendetta against him, and in so doing violated his right to procedural due process. Shortly after filing his original complaint, Dr. *1417Caine attempted to amend his complaint to include a claim under the First Amendment. The district court dismissed Dr. Caine’s suit under Federal Rule of Civil Procedure 12(b)(6) and denied his request to file an amended complaint under Rule 15(a). The majority affirms these rulings today. In so doing, the majority acts with unseeming haste in prejudging a case that may have merit. Further, the majority flatly ignores the clear dictates of Rule 12(b)(6) and Rule 15(a). I therefore dissent.
I.
The facts are adequately set out in the panel opinion, 905 F.2d 858, together with the majority en banc opinion. I emphasize two points the majority glosses over.
First, this case was dismissed pursuant to Rule 12(b)(6). We must therefore accept Dr. Caine’s allegations as true — not as unsubstantiated allegations. Dr. Caine’s complaint does not merely “shine[] a different light on the formalities observed,” as the majority contends. Instead, the facts alleged in the complaint must be taken as the true light.
Second, because of the Rule 12(b)(6) standard, we must analyze this case as one of a personal vendetta against Dr. Caine, not as a case of a hospital protecting its patients. The majority opinion concludes that Dr. Caine’s allegations were merely conclusory. Only if you do not accept them. Our pleading is notice pleading, and Dr. Caine alleged ample facts to support his conclusion of bias. I can only suggest that the Court consider Wright’s relatively elementary law school textbook on Federal Courts, 3d Ed. § 68, pp. 319-326. It will find that this careful summary analysis of correct modern pleading is directly contrary to virtually all of the majority opinion’s deprecating analysis of Dr. Caine’s complaint.
The animus between Dr. Caine and the defendants, as thoroughly alleged in the complaint, began when Dr. Hardy and his two other partners undertook to gain an exclusive contract to become the only three doctors to provide anesthesia services for all of the hospital’s patients. This obviously was a move for a monopoly of those services at a public hospital. Dr. Caine vocally opposed such an arrangement. Further, Dr. Caine ran against Dr. Hardy for the chairmanship of the Hinds General Department of Anesthesiology, and lost by only one vote. Shortly thereafter, Dr. Hardy and his partners began telling others that Dr. Caine was a poor doctor. They also sought to have the hospital suspend Dr. Caine’s hospital privileges.
An ad hoc investigating committee began procedures to suspend Dr. Caine’s hospital privileges. Bias was clearly apparent because Dr. Hardy and one of his partners served on the three person investigating committee. Further, the ad hoc committee did not follow the hospital’s bylaws, rules, and regulations. The committee failed to give Dr. Caine the required notice of the hearing and the charges. The ad hoc investigatory committee recommended that the Executive Committee suspend Dr. Caine’s hospital privileges. The Executive Committee, of which Dr. Hardy and one of his partners were also members, followed this recommendation. This committee failed to give Dr. Caine notice or opportunity to be heard — thereby violating the medical staff rules. The procedural defaults at all stages are alleged in thorough detail in thirteen pages of the complaint. Thus, we have a case of Dr. Caine’s competitors, whom Dr. Caine had publicly criticized and opposed on professional issues, playing a major role in terminating Dr. Caine’s privileges without following the required procedures and under what should have been the controlling inhibition of a clear conflict of interest.
All of these facts are denominated by the Court’s opinion as resulting in a “concluso-ry” allegation of bias.
II.
The majority concludes that Dr. Caine has set out no cause of action under the Fifth and Fourteenth Amendments for two reasons. First, the majority asserts that Dr. Caine received all the procedural due process to which he was entitled according to Mathews7 and Darlak8 The hospital, *1418they assert, suspended him under an exigent circumstance, a concern for patient safety, and therefore did not have to afford Dr. Caine further process before it deprived him of his hospital privileges. The Constitution only required the hospital to give Dr. Caine post-deprivation due process, and Dr. Caine only complains that he received inadequate pre-deprivation due process. He therefore asserts no cause of action. This also means that Zinermon9 is inapplicable because no due process rights were violated.
The majority misapplies Mathews because it ignores the procedural status of Dr. Caine's case. At the 12(b)(6) stage, we construe all of Dr. Caine’s allegations in the light most favorable to him and accept all of his allegations as true. 5A C. Wright & A. Miller, Federal Practice and Procedure § 1363, at 460-61 (1990). Thus, we must accept Dr. Caine’s assertion that the hospital terminated his privileges out of revenge — not out of a concern for personal safety of patients. Mathews and Darlak are therefore inapplicable. Darlak and Mathews come into play only when there is a valid legal finding that patient safety is at issue. Only then does revenge become an acceptable risk and pre-deprivation due process is not required. Here, there is no such finding. We instead must accept as true Dr. Caine’s allegation that the hospital and the other defendants terminated Dr. Caine’s privileges as the core of a personal vendetta.
Second, the majority argues that the Parratt/Hudson doctrine,10 not Zinermon, applies to this case. According to the Par-ratt/Hudson doctrine, when the conduct of state actors is random and unauthorized, the state cannot foresee, predict, or prevent a deprivation resulting from such conduct. In such a situation, post-deprivation procedure is the only process constitutionally required. Zinermon made a strong and sweeping addition to the Parratt/Hud-son doctrine. Here is one aspect of the en banc court going seriously wrong. Under Zinermon, Parratt/Hudson is not applicable when (1) erroneous deprivation is foreseeable, (2) pre-deprivation process is practicable, and (3) challenged conduct is not “unauthorized,” in that the “State delegated to [the state officials] the power and authority to effect the very deprivation complained of” by the plaintiff. Zinermon, 494 U.S. at -, 110 S.Ct. at 989-90.
Zinermon, not the narrower Par-ratt/Hudson doctrine, applies to this case. The state can be expected to provide pre-deprivation remedies because the three Zinermon requirements are present. First, the deprivation is foreseeable and comes at a predictable time — when the hospital began termination proceedings. The state can know when the deprivation occurs because procedures are initiated, just as in Zinermon. This is not a case of a single state employee acting on his or her own as in Parratt and Hudson. The state in fact acknowledges that such a deprivation is foreseeable because it attempted to develop procedural safeguards to protect against erroneous deprivation. See Plumer v. State of Md., 915 F.2d 927, 931 (4th Cir.1990).
Second, pre-deprivation process is practicable because revenge is at issue — at least at this procedural juncture — not patient safety. Dr. Caine did attach to his original complaint a copy of many hospital records pertaining to his termination. He included a copy of a case history which was developed by the investigating committee that charged him with seriously mishandling a patient. Yet Dr. Caine alleges and therefore establishes as fact that this case had been earlier reviewed in a regular “re-credentialing” proceeding and at that time no issue was raised with respect to it by the Credentials Committee or the Executive Committee. We still must take Dr. Caine’s case as one addressing revenge and not patient safety. The allegations in the corn-*1419plaint are taken as true, not the documents attached to the complaint which are inconsistent with the complaint.
Since the majority considers inconsistent documents outside the complaint, it is engaging in summary judgment procedure without giving Dr. Caine the benefit of filing supplemental sworn evidence. Dr. Caine alleges that he had responses to the charges about the case history in question which prove the charges were advanced as a matter of bias. I remind the Court that “the only information necessary for a decision on [a 12(b)(6) ] motion is to be found in the pleading itself; if outside evidence is considered, the motion becomes one for summary judgment.” 5A C. Wright & A. Miller, Federal Practice and Procedure § 1363, at 460 (1990) (footnote omitted). The majority ignores the nature of a Rule 12(b)(6) motion. It asks only: do the allegations in the pleading state a valid claim for relief? Issues of fact are not decided because the allegations in the complaint are taken as true.
Third, the deprivation was not “unauthorized”, “for the state had delegated to its employees ‘the power and authority to effect the very deprivation complained of here, ... and also delegated to them the concomitant duty to initiate the procedural safeguards.." Plumer, 915 F.2d at 931 (quoting Zinermon, 494 U.S. at -; 110 S.Ct. at 990); see also Matthias v. Bingley, 906 F.2d 1047, 1056 (5th Cir.), modified on other grounds, 915 F.2d 946 (5th Cir.1990). In Parrott and Hudson, on the other hand, “the state employees had no similar broad authority to deprive prisoners of their personal property, and no similar duty to initiate ... the procedural safeguards required before deprivations occur.” See Zinermon, 110 S.Ct. at 990.
This case significantly differs from Par-ratt and Hudson, as the Zinermon case demonstrates. The majority generally limits Zinermon strictly to its facts. Yet Zinermon controls. In the posture of a 12(b)(6) case Dr. Caine’s allegations are true. This is a case of bias. Yet, the majority requires Dr. Caine to come forward with proof of bias and decides itself that there was little, if any, bias. This is an overt, and indeed blatant violation of Rule 12(b)(6) — we must accept as true Dr. Caine’s allegation that the hospital committees were biased. Thus, in Section III of the opinion for the Court we find a meticulous analysis and reliance upon non-facts as to patient safety. They are non-facts because they are not subject to evaluation as to their veracity. The specific requirements of Rule 12(b)(6) have not been met. They are not sworn, they are contrary to the facts as established under Rule 12(b)(6) by Dr. Caine’s pleadings, and also Dr. Caine never had the opportunity to counter them.
The defendants never filed a pleading, thus never denied Dr. Caine’s allegations. Yet the Court decides the case by ignoring his allegations and giving detailed credence to a patient safety issue which is not raised in the case because the defendants never raised it and the plaintiff’s pleadings refute it as a factor.
We cannot conclude what result might occur in this case if this were a summary judgment proceeding or there was a trial. Dr. Caine might well have been able to counter the possible evidence of a threat to patient safety. But he had not the slightest obligation to do so at this stage. His pleadings were based upon a claim that Dr. Hardy’s and the other defendants’ actions were grounded in bias growing out of a personal political dispute. These are the only facts in the posture of this case, and they must be accepted as true.
It is incomprehensible to me that this Court can so totally ignore the certain and inescapable status of this case. Contrary to the literal wording of Section 12(b)(6) and the entire corpus of the law interpreting it, the Court converts the 12(b)(6) proceeding to a trial on the merits and without the slightest authority makes its own evaluation of the case based upon its own creation of evidence that does not exist in the pleadings.
This case in no way limits, modifies, or jeopardizes the rule that a hospital can summarily suspend doctor privileges to protect patients. It does not do so because this is not a case about patient safety — at least at this stage — but instead a case *1420about a personal vendetta against a doctor. The majority decision allows a hospital to terminate privileges out of bias, call it patient safety, and then fail to provide the required pretermination procedural due process. This holding constitutes a license to any public agency to deprive someone of a special right by stating a ground which would constitute an emergency — with no proof thereof — and then prevail in a Rule 12(b)(6) dismissal. This bootstrap device can be used in spite of allegations, which must be taken as true, that the motives for the deprivation were wholly discriminatory and that the procedures violated the United States Constitution. The deceased Dr. Caine’s rights are entitled to total vindication as this case comes to us. I regret that my powers of persuasion are unable to pierce the smokescreen of the Court’s groundless and extralegal analysis.
III.
In Dr. Caine’s original petition, he made no First Amendment claim. He later moved for leave of the district court to allow him to file a first amended complaint which included a free speech cause of action. The district court initially granted Dr. Caine’s request. The district court later changed its mind and denied the request:
Finding that the Amended Complaint fails to state a claim upon which relief can be granted, the Court exercises its discretion pursuant to Federal Rule of Civil Procedure 15(a) to deny Caine’s Motion for Leave to Amend Complaint. Numerous courts have ruled that leave to amend is properly denied when the complaint, as amended, is subject to dismissal. See, e.g., Wedgeworth v. Fibreboard Corp., 706 F.2d 541 (5th Cir.1983); Bache Halsey Stuart Shields Inc v. Tracy Collins Bank & Trust Co., 558 F.Supp. 1042 (D.Utah 1983).
This action by the district court was plain error. Yet, the majority today agrees with the district court, and completely fails to mention, much less consider, the clear text of the rule governing amendments of pleadings, Federal Rule of Civil Procedure 15(a).
The first sentence of Rule 15(a) provides in relevant part that “[a] party may amend the party’s pleading once as a matter of course at any time before a responsive pleading is served.” (emphasis added.) The defendants have never filed a responsive pleading in this case; only a Rule 12(b)(6) motion was filed.11 See Zaidi v. Ehrlich, 732 F.2d 1218, 1219-20 (5th Cir.1984); see also Fed.R.Civ.P. 7(a). Dr. Caine under all federal procedural authority should have been allowed to amend his pleading once “as a matter of course.” Rule 15(a) requires no court permission when no responsive pleading has been filed. The district court thus had no discretion to deny Dr. Caine’s request. “[A] party may amend a pleading once without the permission of the court or the consent of any of the other parties to the action if he does so ... before a responsive pleading has been served." 6 C. Wright, A. Miller, & M. Kane, Federal Practice and Procedure § 1480, 574-75 (1990) (footnotes omitted) (emphasis added). It is axiomatic that neither a 12(b)(6) motion nor a summary judgment motion is a “responsive pleading”. Dr. Caine did not even need to make a motion to file an amended complaint. He already had that right under Rule 15(a). The fact that Dr. Caine filed a motion to amend did not affect his absolute right to file an amended complaint. “If a party erroneously moves for leave to amend before the time for amending as of course has expired, ... the amendment should not be handled as a matter addressed to the court’s discretion but should be allowed as of right." Id. at § 1482, 580 (footnote omitted) (emphasis added); see also Zaidi, 732 F.2d at 1220.
The majority completely ignores the clear and simple dictate of Rule 15(a): Dr. Caine could amend his original petition without court permission because no responsive pleading had been filed. Courts at this stage of litigation do not evaluate under Rule 12(b)(6) the right to amend a *1421complaint, and the district court did not purport to do so. Thus, the district court committed plain error when it prohibited Dr. Caine from filing an amended complaint. The two cases cited by the district court are clearly inapplicable here because in those cases the defendants had filed responsive pleadings. In such a situation, the second sentence of Rule 15(a) applies: “Otherwise a party may amend the party’s pleading only by leave of court or by written consent of the adverse party; and leave shall be freely given when justice so requires.” Only when a responsive pleading has been filed can the court determine if the amended pleading would survive a motion to dismiss under Rule 12(b)(6).
Dr. Caine wished to amend for an extremely serious purpose — to state and undertake to prove a First Amendment claim. “A state may not discharge an employee for exercising his right to free speech on matters of public concern.” Page v. De Laune, 837 F.2d 233, 237 (5th Cir.1988); see also Connick v. Myers, 461 U.S. 138, 146, 103 S.Ct. 1684, 1689, 75 L.Ed.2d 708 (1983). Whether his speech addressed a matter of public concern must be determined by the “content, form, and context of a given statement, as revealed by the whole record.” Connick, 461 U.S. at 147-48, 103 S.Ct. at 1690 (footnote omitted). Yet, the majority today countenances denying Dr. Caine the opportunity to develop the whole record because it has decided for him that he could make no claim to have spoken out on a matter of public concern. This conclusion, again, is overt legal error. The alleged and uncontroverted facts reveal a real likelihood that Dr. Caine could make a valid First Amendment claim.
Dr. Caine spoke out about the quality of health care at the public hospital. The quality of health care inescapably is of public concern. Frazier v. King, 873 F.2d 820, 825 (5th Cir.), cert. denied, — U.S. -, 110 S.Ct. 502, 107 L.Ed.2d 504 (1989). Dr. Caine’s outspoken opposition to the Hardy monopoly move can be treated as an unworthy free speech claim only by an inexplicable desire that the case presented to the court were something other than what it is. The majority fastened upon his allegation that his concern was about loss of work. This allegation, establishing a property interest in his right to sue, cannot be found as a self limiting pleading in the light of his proposed amendment raising the free speech issue. Dr. Caine was speaking out concerning the actions of public officials. Further, the actions would create a monopoly and would bar members of the public from using their own doctors in a public hospital. In short, Dr. Caine asked to allege that he undertook to speak out on issues having clear ramifications that deeply involved matters of public concern. Doctors are intimately associated with such matters. The welfare of the patients — about which Dr. Caine spoke — is always a matter of “serious public concern.” Price v. Brittain, 874 F.2d 252, 258 (5th Cir.1989).
The opinion of the Court denies Dr. Caine the opportunity to assert these claims and develop the record. Instead, it has decided for Dr. Caine what he did and did not say and why. It therefore improperly denies him the chance to develop the content, form, and context of his advocacy. Further, the majority focuses upon motive. A strong element of personal concern necessary to establish the right to sue does not remove speech from the realm of public concern. See Thompson v. City of Starkville, 901 F.2d 456, 465-66 (5th Cir.1990). Courts still must fully analyze the content, form, and context of speech as the Supreme Court required in Connick.
IY.
On this record established law requires that the case be reversed and remanded. Dr. Caine’s representatives should be granted the chance to develop their claims that the defendants violated Dr. Caine’s Constitutional procedural rights under Zin-ermon and the critical free speech right of advocacy as to a matter of obvious public concern. Yet these critical assertions of Constitutional default are treated as trivia by the en banc Court, so much so that no denial or explanation or even answer is permitted. In what appears to be an overwhelming desire in the Court to hold against Dr. Caine, even before the facts *1422are developed, the Court simply ignores the firmly established law which governs this case. There is no doubt about the controlling law of Federal Rules of Civil Procedure 12(b)(6) and 15(a). So the Court in its wholly inappropriate ad hoc drive to deny whatever rights Dr. Caine claimed and might establish simply ignores the law and the procedural posture of the case. “Such result-oriented decision making can only erode respect for the federal judiciary.” Christophersen v. Allied Signal Corp., 939 F.2d 1106, 1137 (5th Cir.1991) (King, J. dissenting opinion).
I must register a strong dissent.
. Mathews v. Eldridge, 424 U.S. 319, 96 S.Ct. 893, 47 L.Ed.2d 18 (1976).
. Darlak v. Bobear, 814 F.2d 1055 (5th Cir.1987).
. Zinermon v. Burch, 494 U.S. 113, 110 S.Ct. 975, 108 L.Ed.2d 100 (1990).
. See Hudson v. Palmer, 468 U.S. 517, 104 S.Ct. 3194, 82 L.Ed.2d 393 (1984); Parratt v. Taylor, 451 U.S. 527, 101 S.Ct. 1908, 68 L.Ed.2d 420 (1981), overruled in part on other grounds, Daniels v. Williams, 474 U.S. 327, 106 S.Ct. 662, 88 L.Ed.2d 662 (1986).
. In their 12(b)(6) motion, defendants added a routine alternative motion for summary judgment. But the defendants and the court treated the motion as a 12(b)(6) motion throughout, and the court's judgment was based upon 12(b)(6).