Opinion ID: 1868029
Heading Depth: 2
Heading Rank: 2

Heading: Dr. Meeks was Acting as an Independent Contractor.

Text: ¶ 29. In Miller I, Justice Mills articulated for the Court five factors to be used in determining whether Dr. Meeks was acting an independent contractor: (1) the nature of the function performed by the physician; (2) the extent of the state's interest and involvement in the function; (3) the degree of control and direction exercised by the state over the physician; (4) whether the act complained of involved the use of judgment and discretion; and whether the physician receives compensation, either directly or indirectly, from the patient for professional services rendered. 762 So.2d at 310. Presiding Justices Pittman and Banks and Justices Smith, Waller, Cobb and myself concurred. Id. Justice McRae concurred in part and dissented in part and Chief Justice Prather did not participate in the opinion. Id. [4] ¶ 30. At the time of the alleged negligence, Dr. Meeks was a professor at UMMC, but was allowed to earn additional income as a member of the University of Mississippi Clinical Associates (UMCA). The UMCA is separate from UMMC and its membership is limited to physicians, dentists and clinicians employed by UMMC. According to the by-laws, The Association shall have final authority over all policies and procedures, subject to limitations imposed by the administration of the University Medical Center, University of Mississippi, and Board of Trustees, Institutions of Higher learning. (Article X Section 1). Additionally, the UMCA by-laws consistently refer to the administration of private outpatient clinics. ¶ 31. Under his employment contract, Dr. Meeks earned a base salary of $77,279 with the right to earn 100% of additional income up to $140,000, and 50% of any additional fees thereafter. This additional money was earned at the UMMC Pavilion, an outpatient clinic located on the campus, referred to as a private clinic on its appointment card. Dr. Meeks was required to submit a Private Practice Income Report once a year to UMMC. In 1993 and 1994, Dr. Meeks paid a self-employment tax on this partnership income. His base salary from UMMC was reported as wages, tips, salaries etc. ¶ 32. In our previous opinion, we stated that UMMC generated the bills and collected the payment for professional services rendered by Dr. Meeks during his time with the Association. Miller I, 762 So.2d at 306. In support of this finding, we relied on the by-laws of the UMCA. However, UMMC's name does not appear on Fox's medical bills. Rather, the name on the bills is the Division of Internal Medicine, which at the time of the alleged malpractice was a partnership between Dr. Meeks and another doctor. The partnership agreement specifically states, the Partners desire to form a partnership for the purposes of providing (1) medical services to patients in the private practice of internal medicine at the University Hospital, and (2) a billing and collection service for the Partnership and others. (Emphasis supplied). While Dr. Meeks asserted in his deposition that the Division of Internal Medicine was a division of UMMC, the plain language of the agreement reveals an intent to form a partnership solely for providing private services. ¶ 33. The Court of Appeals found that all five Miller factors weighed in favor of Dr. Meeks's status as an employee of UMMC. Meeks v. Miller, 956 So.2d 951, 2006 WL 1737757, 2006 Miss.App. LEXIS 500 (Miss.Ct.App.2006). For the following reasons, I find that the Court of Appeals erred and that Dr. Meeks was acting as an independent contractor. (1) The Nature of the Function Performed by the Employee. ¶ 34. In analyzing the nature of the employee's function in previous cases, we have found three factors helpful: (1) whether the doctor was acting in a teaching capacity at the time of treatment; (2) whether the doctor had a private relationship with the patient; and (3) whether the doctor was providing care to an indigent patient. See Sullivan, 768 So.2d at 884-85; Clayton, 826 So.2d at 1285; Watts, 828 So.2d at 798; Mozingo, 828 So.2d at 1252; Corey, 834 So.2d at 685; Johnson, 943 So.2d at 687. If the doctor is teaching, without a private physician-patient relationship, and treating an indigent patient, these facts weigh in favor of the doctor's status as an employee. ¶ 35. In this case, it is undisputed that neither residents nor medical students were present during Fox's visits. Additionally, Fox sought out Dr. Meeks after he was referred by a neighbor. Because Fox was not assigned to Dr. Meeks, there was a private physician-patient relationship. Finally, Fox's daughter stated that his medical bills were paid by a combination of Medicare and other private supplemental heath insurance. Therefore, Fox was a private-pay patient, and Dr. Meeks's deposition testimony supports a finding that Fox was not an indigent patient: Dr. Meeks: Actually, the patients have to have some sort of insurance to be seen [at the Pavilion] is my understanding. So, you know, in that sense they recommend if patients don't have insurance that they go to the Medical Mall to be seen. Q: So, there again, if they require them to have insurance to be seen by you, that means that they will be charged and bebe paying for your services and not be provided free services such as provided by UMC. Correct? Dr. Meeks: That's correct. ¶ 36. The Court of Appeals dismissed these factors and found that the nature of the function performed weighed in favor of finding that Dr. Meeks was an employee. Meeks, 956 So.2d at 951, 2006 Miss.App. LEXIS 500 at ¶ 19. This finding is out of step with our previous cases, and this factor weighs in favor of the trial court's finding that Dr. Meeks was an independent contractor. See Johnson, 943 So.2d at 687; Sullivan, 768 So.2d at 884-85; Clayton, 826 So.2d at 1285; Watts, 828 So.2d at 798; Mozingo, 828 So.2d at 1252; Corey, 834 So.2d at 685. (2) The Extent of the State's Interest and Involvement in the Function. ¶ 37. When examining this factor, we again look to whether the doctor was teaching or supervising medical students or residents and whether the doctor was treating an indigent patient. We have consistently held that [t]he State has a strong interest in maintaining a practical and educational environment for residents and supervising physicians in its state hospitals, meeting the needs of both the physicians and the patients. Johnson, 943 So.2d at 687 ( citing Sullivan, 768 So.2d at 885). Additionally, UMMC is fulfilling its operational purpose under Miss.Code Ann. § 37-115-31 (1996) by providing care to [patients] regardless of [their] ability to pay. Id. See also Clayton, 826 So.2d at 1285-86; Mozingo, 828 So.2d at 1252; Corey, 834 So.2d at 685. ¶ 38. The Court of Appeals found that because the State has an interest in hiring and retaining highly skilled physicians, this second factor weighed in favor of determining that Dr. Meeks was an employee. Meeks, 956 So.2d at 948-49, 2006 Miss. App. LEXIS 500 at ¶ 22-23. However, this again ignores our precedent. In the present case, Dr. Meeks was neither teaching nor supervising any residents, and Fox was not an indigent patient. We have previously held [t]he State does not have any interest in one of its faculty members treating a `private patient.' Bennett, 821 So.2d at 800. Therefore, this factor weighs in favor of finding that Dr. Meeks was acting as an independent contractor. (3) The Degree of Control and Direction Exercised by the State Over the Physician. ¶ 39. The Court of Appeals found that [w]hile being contractually required to maintain membership with the UMCA, Dr. Meeks was prohibited from practicing medicine outside his employment at UMMC. Further, he could only admit patients to UMMC and no other hospital. Meeks, 956 So.2d at 949, 2006 Miss.App. LEXIS 500 at ¶ 25. However, his UMMC employment contract does not contain these restrictions. The contract simply states that he must report additional income from all patient care related income at the Medical Center, Department of Veterans Affairs Medical Center, or elsewhere.  (Emphasis supplied). It was his partnership agreement, the Division of Internal Medicine, and not UMMC or UMCA, that restricted his practice to UMMC. As discussed above, the record is unclear whether the Division of Internal Medicine was a division of UMMC or a private partnership as stated in its partnership agreement. ¶ 40. In our previous opinion, we found that UMMC exercises considerable control over the treatment of patients at the clinic. Miller I, 762 So.2d at 306. However, the record shows only that the clinics were subject to UMMC regulations, despite Dr. Meeks's claims that UMMC controlled the entire relationship. While being subject to regulations is evidence of some control, this does not support our previous conclusion that UMMC exercise[d] considerable control. Id. (Emphasis supplied). ¶ 41. On the other hand, plaintiffs allege that at all times Dr. Meeks held himself out to be a private practitioner. UMMC did not assign Fox to Dr. Meeks, and at no time was Dr. Meeks teaching or supervising residents or medical students. Indeed, his employment contract, the UMCA bylaws, and the Division of Internal Medicine partnership agreement all refer to the clinic as private practice. ¶ 42. The majority asserts that Dr. Meeks was part of a medical practice plan and relies on our opinion in Mozingo. Mozingo held that where the defendant was part of a medical practice plan, he was considered a member of a political subdivision for purposes of Miss.Code Ann. § 11-46-1(I) (Rev.2002). 828 So.2d at 1254-55. However, at the time in question, there were no such well-defined practice plans such as the UAS. Unlike the UAS, Dr. Meeks was in a private partnership. Id. at 1255. Accordingly, this factor weighs in favor of the trial court's finding that Dr. Meeks was acting as an independent contractor. (4) Whether the Act Complained of Involved the Use of Judgment and Discretion. ¶ 43. This fourth factor is practically the same in every case. In Sullivan we noted that [w]hile this is a consideration, it is not determinative. Virtually every act performed by a person involves the exercise of some discretion. . . . This is especially true of physicians who are bound to exercise their judgment without interference from others. 768 So.2d at 885; see also Johnson, 943 So.2d at 688. Accordingly, I would eliminate this factor as it has not proved to be helpful when determining physician employment status. (5) Whether the Physician Receives Compensation, Either Directly or Indirectly, from the Patient for Professional Services Rendered. ¶ 44. This final factor often turns on whether the patient was indigent, whether UMMC directly billed the patient, or whether the doctor was placed on a set salary. Sullivan, 768 So.2d at 885-86; Mozingo, 828 So.2d at 1253; Smith, 765 So.2d at 550; Corey, 834 So.2d at 685. As previously discussed, Fox had private insurance. He was billed by the Division of Internal Medicine, Dr. Meeks's private partnership. Finally, the money received from his practice at the clinic was money he earned above his base salary. Thus, the final factor weighs in favor of finding Dr. Meeks an independent contractor.