Opinion ID: 1510712
Heading Depth: 1
Heading Rank: 3

Heading: Ex Parte Communications With Plaintiff's Treating Physicians

Text: Plaintiff's motion is based upon this Court's decision in State ex rel. Woytus v. Ryan, 776 S.W.2d 389 (Mo. banc 1989), and upon McClelland v. Ozenberger, 805 S.W.2d 264 (Mo.App.1991). In Woytus, this Court held that we would not require the plaintiff to execute medical authorizations allowing defendants to have ex parte discussions with the plaintiff's treating physicians. In Woytus, we were not asked to rule, and we did not rule, on the issue of whether the medical privilege contained in section 491.060(5) prohibits such ex parte discussions. Woytus overruled State ex rel. Stufflebam v. Appelquist, 694 S.W.2d 882 (Mo.App.1985), in which the Court of Appeals, Southern District, required the plaintiff to execute a written authorization permitting the plaintiff's treating physician to engage in ex parte discussions with the defendant's lawyer if the physician was willing to do so. In McClelland , the Court of Appeals, Western District, held that ex parte discussions between plaintiff's treating physician and defense counsel were improper. The court correctly observed that our opinion in Woytus shows a judicial philosophy that discourages ex parte conversations with plaintiff's doctor. McClelland, 805 S.W.2d at 268. The court of appeals in McClelland remanded for an evidentiary hearing by the trial court to determine whether plaintiff was prejudiced by such contacts. The court of appeals granted a new trial unless the defendant proved no prejudice. This case presents us with the issue of whether ex parte communications with the plaintiff's treating physician are prohibited during the discovery period of litigation and if so, what remedy is available to plaintiff. The plain and simple answer to this issue is found in the express language of section 491.060(5), RSMo Supp.1992, which reads as follows: The following persons shall be incompetent to testify: (5) A physician licensed under chapter 334, RSMo, a licensed psychologist or a dentist licensed under chapter 332, RSMo, concerning any information which he may have acquired from any patient while attending him in a professional character, and which information was necessary to enable him to prescribe and provide treatment for such patient as a physician, psychologist or dentist. This statute only covers the disclosure of confidential medical information by testimony in court or by formal discovery such as interrogatories, depositions, or production of medical records, hereinafter referred to as the physician-patient testimonial privilege. The statute makes no reference to any duty of the physician to the patient not to disclose confidential medical information of the patient outside the courtroom such as in informal conversation, in interviews, or in correspondence. In Woytus we made the same incorrect assumption our courts have made previously under the statute in assuming without stating that the medical privilege contained in section 491.060(5) encompasses all of the law of physician-patient privilege when in fact, by its express terms, it only speaks to the testimonial privilege. In State v. Beatty, 770 S.W.2d 387, 391-92 (Mo.App.1989), the Court of Appeals, Southern District, recognized the limited nature of the statute by holding that by its terms section 491.060(5) only governs testimony. In Beatty the physician, a psychiatrist, made an anonymous telephone call to Crime Stoppers reporting information that his patient had disclosed to him in confidence that she had committed a robbery. In the criminal prosecution the defendant, who was the patient, sought to exclude her statements to the police and the articles seized in a search of her apartment following the anonymous call on the grounds that they were the fruits of an illegal search because the telephone call was a gross violation of the defendant's rights under the physician-patient privilege. The defendant relied on section 491.060(5) as the sole basis for her claim. The Southern District held that section 491.060(5) was limited to testimony and does not prohibit any other oral communications such as this doctor's telephone call. The Southern District stated: If the legislature sees fit to modify the confidentiality statute so as to prohibit physicians ... from revealing ... confidential communications they have received from their patient ..., it has a right to do so; but, until it does, the only prohibition dictated by the statute is that they cannot testify in a court proceeding regarding such confidential communication. Beatty, 770 S.W.2d at 392. One earlier case had suggested this same idea by way of dicta. In Cramer v. Hunt, 154 Mo. 112, 55 S.W. 258 (1900), this Court discussed section 491.060(5) in the context of a case where plaintiff sued a physician for damages arising from an abortion performed on plaintiff's wife. In discussing whether this lawsuit by the husband was a waiver of the wife's medical privilege, this Court observed in dicta that while the law places no restriction upon [the wife] or the [physician] as to what they respectively say to others about what occurred, it prohibits [the physician] from testifying in any case to such facts without her consent.... Id. 55 S.W. at 260. We agree that the language in section 491.060(5) only covers the testimonial privilege. Moreover, there was no physician-patient privilege under the common law in Missouri or elsewhere. Klinge v. Lutheran Medical Center of St. Louis, 518 S.W.2d 157, 164 (Mo.App.1975). See also Daniel W. Shuman, The Origins of the Physician-Patient Privilege and Professional Secret, 39 S.W.L.J. 661, 676-77 (1985). However, this does not necessarily mean that there is now no protection in our law establishing a duty of the physician not to disclose confidential information of the patient outside of the courtroom such as in an informal conversation, in interviews, or in correspondence. In fact, in Brandt II we discuss the obligation of the physician not to disclose confidential medical information; this obligation arises out of the fiduciary relationship between the physician and the patient. We also discuss in Brandt II the enforcement of this obligation of confidentiality through a civil action for damages as well as the patient-litigant waiver of this obligation. For purposes of the present case ( Brandt I ) we hold that there is nothing in section 491.-060(5) nor in our common law that constitutes grounds for granting plaintiff a new trial because of his physicians' out-of-court disclosures of medical information. Thus, there is no sanction or remedy in the present case for ex parte communications with plaintiff's treating physicians. We overrule McClelland v. Ozenberger, 805 S.W.2d 264 (Mo.App.1991), to the extent it is inconsistent with this holding. We reaffirm our holding in Woytus that we will not require the plaintiff to execute medical authorizations authorizing his treating physician to engage in ex parte discussions. It should be noted that the physician cannot be forced over the physician's own objection to engage in informal ex parte discussions with the defense attorney. The contention of the defense in the present case that they were entitled to talk to Dr. Kodner and Dr. Myers acknowledged that such a right is subject to the consent of the doctors and, in fact, in the present situation both doctors willingly consented to talk to defendant's attorneys. This limitation embodies the proposition that no witness is forced to participate in discovery except through the formal discovery procedures. If a witness refuses to be interviewed or to give a statement, the attorney's only practical recourse is to take the witness' deposition.