Opinion ID: 1753322
Heading Depth: 1
Heading Rank: 4

Heading: the dual capacity approach

Text: The California Supreme Court first recognized company physicians operate in a dual capacity in Duprey v. Shane, 39 Cal. 2d 781, 249 P.2d 8 (1952). The plaintiff was employed in a chiropractic clinic. She experienced shoulder and arm pain after grabbing a patient who had begun to fall off the examination table; and was treated by her employer, Dr. Shane, and by her fellow employee, Dr. Harrison. Plaintiff alleged the treatments aggravated her injuries and resulted in further disability. She was later diagnosed as having an injury which was the result of the chiropractors' treatment of her following the original injury. The Court held Mrs. Duprey could maintain an action in tort against her employer, Dr. Shane, and against her co-worker, Dr. Harrison. The Court found there was no reason why Mrs. Duprey should lose the right to sue for malpractice just because the medical treatment was rendered by her employer. The Court noted Dr. Shane exhibited two relationships toward his employee, that of an employer and that of a doctor. Id. at 15. In treating the injury Dr. Shane did not do so because of the employer-employee relationship, but did so as an attending doctor and his relationship to [plaintiff] was that of doctor and patient. Id. at 15. As to the malpractice action against Dr. Harrison, plaintiff's co-worker, the Court found Dr. Harrison was in the same position he would have been in had plaintiff been referred to him by her employer for the treatment of this work-related injury. Therefore, plaintiff could maintain a medical malpractice action against a fellow employee. A more recent jurisdiction to adopt the dual capacity approach is that of Colorado. In Wright v. District Ct. In & For City of Jefferson, 661 P.2d 1167 (Colo.1983), the Colorado Supreme Court held a medical malpractice action could be filed against a plant physician by an employee who had been treated by the physician. The physician was employed by Adolph Coors Company to provide medical services on a full time basis. The employee, Troy Cobb, was treated by the physician, Dr. Lloyd Wright, for back injuries suffered in an on-site accident. Cobb sued Dr. Wright for alleged misdiagnosis of the injury and for allowing Cobb to return to work before Cobb had fully recuperated. The Court found Dr. Wright's status as a co-worker of Cobb's was not a total bar against malpractice actions brought by employees like Cobb. Dr. Wright's relationship with Cobb was identical to that of a doctor in private practice with a patient. This relationship is distinct from the employment relationship; it entails different rights and duties. Clearly, a private doctor would be liable to Cobb for malpractice. There is no logical reason to treat company physicians differently. Thus, the rule which immunizes employees from suits by their co-employees for negligence within the course of employment is inapplicable here. Wright, 661 P.2d at 1168. The Colorado Court rejected the reasoning adopted by Michigan and New York who have declined to apply the dual capacity approach to malpractice occurring at a company clinic, but allow malpractice actions by public employees who are treated by hospitals where they work when the hospital also treats the general public. It is not the public practice of medicine which creates a dual capacity for the attending physician; it is the very practice of medicine, with its special duties and responsibilities, which charges a doctor with all of the obligations which normally arise in the doctor-patient relationship. One's need for protection from medical malpractice is not affected by the configuration of the employment relationship or the location of treatment. Wright, 661 P.2d at 1170. The Court also discussed reasons why allowing malpractice actions to be brought against physicians is not inconsistent with either the policies underlying their Workmen's Compensation Act or its general rule of co-employee immunity. The five reasons cited by the Colorado Court are discussed in more detail in Jenkins, The No-Duty Rule in New York: Should Company Doctors Be Considered Co-employees? 9 Hofstra L.Rev. 665, 675-80 (1981). They were summarized in support of the dual capacity approach, as follows: First, the worker's compensation scheme is based on the fact that most workplace accidents occur without fault or in a manner making assignment of fault nearly impossible. This assumption is not relevant to injuries resulting from medical malpractice, which occurs away from the production area, is easier to identify, and can be judged in light of ascertainable medical standards. Second, co-employee immunity embodies a recognition that workplace accidents are less a result of unreasonable conduct than a concomitant of a highly technological age. Unlike the occupational accidents which are an inevitable consequence of working with complex equipment, medical malpractice is neither inevitable nor a risk that is inherent in the production process. Third, worker's compensation is based in part on the premise that the employer is in a better position than a co-employee to shoulder the risk of an industrial accident. But the higher income and professional liability insurance coverage of company physicians set them apart from the average co-employee. Fourth, a company physician does not participate in the mutual compromise of rights which is the essence of the worker's compensation scheme. Because the doctor is removed from the production area, he or she is extremely unlikely to be injured on the job. Thus, realistically, the doctor is not sacrificing a common law right to sue in exchange for co-employee immunity. Fifth, the worker's compensation law provides employers with an economic incentive to deter future accidents by careful job training, supervision, and organization of the workplace. But because a company lacks significant control over the professional acts and exercise of judgment by a company physician, extending co-employee immunity to the physician carries little deterrent effect against the company. Most importantly, co-employee immunity removes almost all deterrence to negligence by the company physician, who, alone among doctors, would be invulnerable to malpractice actions. Thus, leaving company physicians open to negligence suits satisfies the compensatory purposes of worker's compensation without frustrating the basic principle of a mutual compromise of rights. The dual capacity approach leaves the employer liable under worker's compensation for injuries which the employee is exposed to by employment in the industryinjuries which arise out of a risk or hazard to which the employee is exposed in the performance of the job. Wright, 661 P.2d at 1170, 1171. The Colorado court concluded medical malpractice was not an inherent risk of the brewing business. Id. at 1171. Dr. Wright, in treating Cobb, owed Cobb the same duty owed to any other patient who is treated by a doctor. Thus, under the Colorado Worker's Compensation Act, Dr. Wright operated in two capacities, that of a physician and also that of a co-worker towards Cobb. Cobb was allowed to sue Dr. Wright for malpractice because the alleged malpractice took place in the course of the doctor-patient relationship and outside the scope of the employment relationship.... Id. We agree with the reasoning of the California and Colorado courts and note several other jurisdictions have also adopted the dual capacity approach. Vesel v. Jardine Mining Co., 110 Mont. 82, 100 P.2d 75 (1939); Robbins v. Seekamp, 444 A.2d 537 (N.H.1982); Guy v. Arthur Thomas Co., 55 Ohio St.2d 183, 378 N.E.2d 488 (1978); Tatrai v. Presbyterian University Hospital, 497 Pa. 247, 439 A.2d 1162 (1982). The rationale underlying this duty-based doctrine was perhaps best explained by a California court of appeal: Characterizing a defendant as an employer [or co-employee] and therefore automatically cloaked with immunityis a simplification that tends to cloud proper analysis. The focus should be on the defendant's responsibility for his own acts or omissions where a different duty to take care or make sure that care is taken arises than that imposed on an employer [or co-employee]. Our society is pluralistic. The same person (real or artificial) from time to time obviously adopts many roles in relationship with others....       ... The dual capacity concept is within the highest tradition of analytical jurisprudence. Dual capacity recognizes the long accepted doctrine that every person is a bundle of rights, no rights, liabilities and immunities. Douglas v. E. & J. Gallo Winery, 69 Cal. App.3d 103, 110, 137 Cal.Rptr. 797, 801 (5th Dist.1977).