Opinion ID: 1258944
Heading Depth: 2
Heading Rank: 9

Heading: ex parte interviews with litigant's doctor

Text: Should the law permit a party litigant to privately interview and obtain medical information from the opposing party's doctor without the opposing party's knowledge or consent? Published decisions of federal courts and courts of our sister states have debated this question with great thoroughness and have given conflicting answers. (See generally, Annot., Discovery: Right to Ex Parte Interview with Injured Party's Treating Physician (1986) 50 A.L.R.4th 714.) There is also no shortage of commentary in legal publications. (See, e.g., Woodard, Shielding the Plaintiff and Physician: The Prohibition of Ex Parte Contacts with a Plaintiff's Treating Physician (1991) 13 Campbell L.Rev. 233; Corboy, Ex Parte Contacts Between Plaintiff's Physician and Defense Attorneys: Protecting the Patient-Litigant's Right to a Fair Trial (1990) 21 Loy. U. Chi. L.J. 1001; Asher, Ex Parte Interview with Plaintiff's Treating Physicians  The Offensive Use of the Physician-Patient Privilege (1990) 67 U.Det. L.Rev. 501; Note, Restricting Ex Parte Interviews with Nonparty Treating Physicians: Crist v. Moffatt (1990) 69 N.C.L.Rev. 1381; Note, Defendants' Right to Conduct Ex Parte Interviews with Treating Physicians in Drug or Medical Device Cases (1989) 73 Minn. L.Rev. 1451.) The question is not squarely posed here. We must decide in this case whether disclosure of medical information during an interview is an actionable violation of the Confidentiality of Medical Information Act, but a conclusion that the conduct is not actionable under the statute does not mean that courts are powerless to prevent such interviews or to impose conditions. Nevertheless, the majority's rather offhand disapproval of Torres v. Superior Court (1990) 221 Cal. App.3d 181 [270 Cal. Rptr. 401] and Province v. Center for Women's Health & Family Birth (1993) 20 Cal. App.4th 1673 [25 Cal. Rptr.2d 667] to the extent [they] could be read to prohibit all ex parte contacts between a physician and his [ sic ] attorneys or insurers (maj. opn., ante, p. 41) makes further discussion necessary. The relationship of doctor to patient is a fiduciary one. ( Stafford v. Shultz (1954) 42 Cal.2d 767, 777 [270 P.2d 1].) A doctor has not only a legal obligation, grounded in the doctor-patient privilege (Evid. Code, § 994) and the constitutional right of privacy (Cal. Const., art. I, § 1), but also a professional obligation to maintain the secrecy of patient confidences. (See Bus. & Prof. Code, § 2263 [willful, unauthorized violation of professional confidence constitutes unprofessional conduct].) The Judicial Council of the American Medical Association puts it this way: The information disclosed to a physician during the course of the relationship between physician and patient is confidential to the greatest possible degree. The patient should feel free to make a full disclosure of information to the physician in order that the physician may most effectively provide needed services. The patient should be able to make this disclosure with the knowledge that the physician will respect the confidential nature of the communication. The physician should not reveal confidential communications or information without the express consent of the patient, unless required to do so by law. (Current Opinions of the Council on Ethics and Judicial Affairs of the American Medical Association (1986) § 5.05, p. 21.) As we have seen, a patient makes a limited waiver of the doctor-patient privilege by bringing an action for personal injury or medical malpractice. During the course of such litigation, the defendants have a right to discover any information in the possession of the plaintiff's treating physicians that is directly relevant to matters at issue and essential to their fair resolution. Thus, the question is not whether relevant information must be disclosed, but the method of such disclosure. (See Manion v. N.P.W. Medical Center (M.D.Pa. 1987) 676 F. Supp. 585, 593 [... the prohibition against unauthorized ex parte contacts ... affects defense counsel's methods, not the substance of what is discoverable].) Some courts see no reason to bar or restrict defense counsel from conducting ex parte interviews of the plaintiff's treating physicians (e.g., Lewis v. Roderick (R.I. 1992) 617 A.2d 119; Domako v. Rowe (1991) 438 Mich. 347, 360 [475 N.W.2d 30, 36]; Felder v. Wyman (D.S.C. 1991) 139 F.R.D. 85; Coralluzzo v. Fass (Fla. 1984) 450 So.2d 858; Doe v. Eli Lilly & Co. (D.D.C. 1983) 99 F.R.D. 126; Trans-World Investments v. Drobny (Alaska 1976) 554 P.2d 1148, 1152), and, in fact, have directed plaintiffs to execute authorization forms to facilitate the interviews. These courts emphasize, as does the majority here, that private interviews save time and money when compared to more formal methods of discovery ( Domako v. Rowe, supra, 438 Mich. at p. 361; Doe v. Eli Lilly & Co., supra, at p. 128), and that the information disclosed in the ex parte interviews would be disclosed eventually anyway. They also maintain that private interviews are conducive to spontaneity and candor in a way depositions can never be ( Doe v. Eli Lilly & Co., supra, at p. 128) and that they speed the settlement process by encouraging early investigation and evaluation of claims ( Trans-World Investments v. Drobny, supra, 544 P.2d at p. 1152; Domako v. Rowe, supra, 438 Mich. at p. 361). Taking a contrary position, other courts have held that in medical malpractice or personal injury litigation, defense counsel should never be permitted to interview a plaintiff's nonparty treating physician ex parte without the plaintiff's consent. ( State ex rel. Kitzmiller v. Henning (1993) 190 W. Va. 142 [437 S.E.2d 452]; Cua v. Morrison (Ind. 1994) 636 N.E.2d 1248, adopting opn. published at (Ind. Ct. App. 1993) 626 N.E.2d 581; Crist v. Moffatt (1990) 326 N.C. 326, 332 [389 S.E.2d 41, 45]; Duquette v. Superior Court (1989) 161 Ariz. 269 [778 P.2d 634]; Loudon v. Mhyre (1988) 110 Wn.2d 675 [756 P.2d 138]; Linton v. City of Great Falls (1988) 230 Mont. 122 [749 P.2d 55]; Petrillo v. Syntex Laboratories, Inc. (1987) 148 Ill. App.3d 581, 591 [102 Ill.Dec. 172, 499 N.E.2d 952]; Nelson v. Lewis (1987) 130 N.H. 106 [534 A.2d 720]; Smith v. Ashby (1987) 106 N.M. 358 [743 P.2d 114]; Roosevelt Hotel Ltd. Partnership v. Sweeney (Iowa 1986) 394 N.W.2d 353; Weaver v. Mann (D.N.D. 1981) 90 F.R.D. 443, 445; Anker v. Brodnitz (1979) 98 Misc.2d 148, [413 N.Y.S.2d 582]; Wenninger v. Muesing (1976) 307 Minn. 405 [240 N.W.2d 333]; Fields v. McNamara (1975) 189 Colo. 284 [540 P.2d 327]; Hammonds v. Aetna Casualty & Surety Company, supra, 243 F. Supp. 793.) [3] These courts point out that the spontaneity and candor that is one of the claimed virtues of informal interviews is also its principal vice. In the relaxed atmosphere of a private interview, a nonparty treating physician may be led to disclose confidential information not relevant to the litigation and therefore protected by the doctor-patient privilege and the doctor's professional obligation to preserve confidentiality. [4] (See, e.g., Karsten v. McCray (1987) 157 Ill. App.3d 1, 14 [109 Ill.Dec. 364, 509 N.E.2d 1376, 1384]; Wenninger v. Muesing, supra, 307 Minn. 405, 410-411 [240 N.W.2d 333, 336-337]; Manion v. N.P.W. Medical Center, supra, 676 F. Supp. 585, 594.) The very possibility of unauthorized disclosure, these courts maintain, is destructive of the trust essential to a secure and productive doctor-patient relationship: The presence of the patient's counsel at the doctor's interrogation permits the patient to know what his doctor's testimony is, allays a patient's fears that his doctor may be disclosing personal confidences, and thus helps preserve the complete trust between doctor and patient which is essential to the successful treatment of the patient's condition. ( Wenninger v. Muesing, supra, 307 Minn. 405, 411 [240 N.W.2d 333, 337]; accord, Manion v. N.P.W. Medical Center, supra, 676 F. Supp. 585, 594; Loudon v. Mhyre, supra, 110 Wn.2d 675, 679 [756 P.2d 138, 141].) In medical malpractice actions, moreover, defense counsel may use an ex parte interview with the plaintiff's doctor to solicit sympathy for the defendant, and thereby compromise the doctor's loyalty to the patient: An unauthorized ex parte interview could disintegrate into a discussion of the impact of a jury's award upon a physician's professional reputation, the rising cost of malpractice insurance premiums, the notion that the treating physician might be the next person to be sued, and other topics which might influence the treating physician's views. The potential for impropriety grows even larger when defense counsel represents the treating physician's own insurance carrier.... ( Manion v. N.P.W. Medical Center, supra, 676 F. Supp. 585, 594-595; see also Duquette v. Superior Court, supra, 161 Ariz. 269, 276 [778 P.2d 634, 641]; Anker v. Brodnitz, supra, 98 Misc.2d 148, 153 [413 N.Y.S.2d 582, 585].) The New Jersey Supreme Court has articulated a middle ground, in an attempt to reconcile the competing interests. In Stempler v. Speidell (1985) 100 N.J. 368 [495 A.2d 857, 50 A.L.R.4th 699], the court crafted a rule under which plaintiffs may be required to authorize their treating physicians to hold ex parte interviews with attorneys for the defendants, but on the condition that the defense lawyers provide the plaintiff's lawyers with reasonable notice of the time and place of the interviews, a description of the anticipated scope of the interviews, and assurances that the physicians will be advised that their participation is entirely voluntary. The aim of the procedure is to provide plaintiffs' lawyers with an opportunity to advise the doctors in advance of any appropriate concerns as to the proper scope of the interview, and the extent to which plaintiff continues to assert the patient-physician privilege with respect to that physician. ( Id. at p. 382 [495 A.2d at p. 864].) The court recognized that in particular cases these safeguards might not be adequate: Plaintiff may also seek and obtain a protective order if under the circumstances a proposed ex parte interview with a specific physician threatens to cause such substantial prejudice to plaintiff as to warrant the supervision of the trial court. Such supervision could take the form of an order requiring the presence of plaintiff's counsel during the interview or, in extreme cases, requiring defendant's counsel to proceed by deposition. ( Id. at p. 383 [495 A.2d at pp. 864-865].) The majority does not suggest that a court could order a plaintiff to authorize defense counsel to interview the plaintiff's treating physicians ex parte. Absent such authorization, I would expect that few defense counsel would attempt to interview a plaintiff's treating physician and few physicians would consent to be interviewed. [5] As I understand it, the majority holds only that if an ex parte interview does occur without the plaintiff's knowledge or consent, the physician does not thereby violate the Confidentiality of Medical Information Act and that Norcal's ex parte interviews of Yamaguchi are not actionable under the facts of this case. Given this limited holding, issues concerning the propriety of ex parte interviews of nonparty treating physicians are certain to reach this court again. As has occurred in other states, such issues may arise when a plaintiff, invoking a trial court's inherent authority to supervise discovery, moves for a protective order to bar or restrict ex parte interviews, or when a plaintiff moves at trial to exclude information disclosed during such interviews. When these issues return, in this or some other manner, I would hope that this court gives them the thorough consideration and analysis they deserve.