Court Opinion

ID: 9760171
Source: CourtListenerOpinion
Date Created: 2023-08-29 00:41:57.015385+00
Date Added: 2024-06-11T07:29:08.768445
License: Public Domain

*369DISSENTING OPINION BY
LALLY-GREEN, J.:
¶ 1 I respectfully dissent. Initially, I note that as an intermediate appellate court, we should be reluctant to expand tort liability in the absence of clear guidance from our Supreme Court or the Legislature. See Excavation Techs. v. Columbia Gas Co., 936 A.2d 111 (Pa.Super.2007), appeal granted, 597 Pa. 63, 950 A.2d 267 (Pa.2008).
¶ 2 Our Supreme Court has not spoken directly on this important issue. I would predict, however, that the high Court would decline to impose tort liability based on its opinion in Physicians Ins. Co. v. Pistone, 555 Pa. 616, 726 A.2d 339 (1999).
¶ 3 Pistone arose in the insurance context. In that case, the defendant physician treated a woman for gallstones. In the course of an examination, he “fondled her breasts, exposed his genitals and masturbated in front of her.” Id. at 340. The question was whether the physician’s acts were covered by a policy insuring against “injury arising out of the rendering of or failure to render professional health care services[.]” Id. The Court “granted allowance of appeal to determine when conduct constitutes the rendering of professional health care services.” Id.
¶ 4 The Court ultimately adopted a narrow test that “looks to whether the act that caused the alleged harm is a medical skill associated with specialized training.” Id. at 344. In doing so, the Court considered but expressly rejected two broader tests. First, the Court rejected a test that would look to whether there was a “substantial nexus” between the doctor’s act and his role as a care provider. The Court also rejected a test that would consider whether the harmful act was “intertwined with and inseparable from” his role as a care provider. Id. The Court concluded that no coverage was available because the physician’s assault did not constitute a “medical skill associated with specialized training.” See id. at 344.
¶ 5 Pistone is instructive. Here, Appellant Joanne Thierfelder (“Wife”) couches her negligence claim expressly in terms of medical malpractice. She claims that Dr. Wolfert’s actions fell below the standard of care for general practitioners because he engaged in a consensual affair with her. In my view, these allegations do not meet the narrow test of Pistone. Wife does not claim that Dr. Wolfert proposed sexual relations as part of his treatment of her medical needs. Rather, she simply alleges that Dr. Wolfert abused his position of power and took advantage of her vulnerable state in order to carry on the affair with her. She also alleges that Dr. Wol-fert distorted the doctor-patient relationship in order to satisfy his own needs, to the detriment of the needs of his patient.
¶ 6 While those allegations may conceivably fit within the “substantial nexus” test or the “inseparable and intertwined” test, our Supreme Court rejected both of those tests in Pistone. Following Pistone, I would hold that a consensual, non-medical sexual affair between doctor and patient does not constitute the rendering of a “medical skill associated with specialized training.” See also Smith v. Friends Hosp., 928 A.2d 1072, 1076 (Pa.Super.2007) (“a complaint sounds in medical malpractice where the conduct at issue constitutes an integral part of the process of rendering medical treatment, and where the complaint alleges that the injury caused to the patient occurred during, and as a direct result of the performance of professional services.”) (internal quotations omitted). *370Thus, I would hold that Dr. Wolfert’s actions, while unethical, do not constitute medical malpractice.
¶ 7 In the instant case, the Majority announces for the first time1 that any physician, whether a specialist or not, has a duty to refrain from a sexual affair with his patient, so long as: (1) the physician is treating the patient for an “emotional condition” or “psychological problems”; and (2) the patient alleges that the affair worsened the psychological condition. Majority Opinion at 368. While I do not doubt the good intentions of this new and somewhat vaguely formulated expansion of tort liability, I believe that it runs contrary to guiding Supreme Court precedent.2 The high Court is, of course, free to revisit its precedent and to expand the rule in its wisdom.3 At present, however, I would affirm the trial court’s decision to dismiss Wife’s claims as a matter of law. Because the Majority takes a contrary course, I respectfully dissent.
¶ 8 ORIE MELVIN and SHOGAN, JJ., join.

.In Pistone, our Supreme Court alluded to out-of-state cases holding that a psychiatrist has a special duty of care to refrain from having an affair with his patient because of the abuse of the transference phenomenon. Pistone, 726 A.2d at 343 n. 3. The Pistone Court did not expressly adopt such a holding. Similarly, in Long v. Ostroff, 854 A.2d 524, 528 (Pa.Super.2004), appeal denied, 582 Pa. 700, 871 A.2d 192 (2005), this Court simply noted that out-of-state cases imposing such tort liability on psychiatrists are "not binding.”
In Long, this Court held that a general practitioner does not have a duty of care to refrain from having a sexual affair with the patient’s spouse. I agree with the Majority that Long does not control the instant case. However, dicta in that case does strengthen Dr. Wolfert's position. See id. ("the Mazza decision, with its countless references to a psychiatrist’s special duty, does not extend to general practitioners.”)

. The Majority engages in a generalized duty of care analysis pursuant to Althaus v. Cohen, 562 Pa. 547, 756 A.2d 1166 (2000). While it is appropriate to do so, we must pay particular attention to the fact that medical malpractice issues (and their insurance ramifications) are increasingly the province of specialized rules promulgated by the Legislature and our Supreme Court.

. Wife's expert, Dr. Robert L. Perkel, is a board-certified family practice physician and professor of medical ethics who apparently taught Dr. Wolfert in medical school. Dr. Perkel is of the strong view that any sexual relationship between a doctor and a current patient is a fundamental violation of the doctor’s duty of care to the patient, regardless of whether the doctor is treating the patient for emotional or. psychological problems. R.R. 354a. Thus, Dr. Perkel would propose a rule even more far-reaching titan that of the Majority.