Court Opinion

ID: 9537610
Source: CourtListenerOpinion
Date Created: 2023-08-07 07:20:25.958047+00
Date Added: 2024-06-11T14:56:49.489999
License: Public Domain

BURNETT, Judge,
specially concurring.
I join in the Court’s opinion. It should be emphasized that this appeal would not have arisen but for a local standard of medical practice which, we are told, allows a recommendation from a committee like the tumor board to be substituted for a second opinion from a consulting physician. I write separately to suggest that any such local standard should be re-examined.
As today’s opinion demonstrates, our Legislature has erected formidable barriers to disclosure of certain activities conducted by in-hospital medical staff and medical society committees. When such a committee is thrust, perhaps unwittingly, into the role of a substitute consultant, there are potential pitfalls for both doctor and patient. Unless all affected parties consent to voluntary disclosure of information, the primary physician cannot fully explain in court the basis of his decisions relating to patient care. Conversely, the patient is relegated to asserting a claim of malpractice before he can make even a limited inquiry to the committee about its evaluation of his case. Moreover, the committee is immune from any civil liability for its “use” of information concerning the patient. I.C. § 39-1392c.
The result is anomalous. Although a local standard of practice may treat the committee as a consultant, the committee has little accountability toward, or duty to communicate with, the doctor and his patient. It is, in truth, a phantom consultant.
I do not suggest that committees like the tumor board should discontinue evaluating current eases. The case method is a valuable tool in medical study. Unless a patient is deceased or entirely cured, any review of his case will afford an opportunity for a committee to recommend appropriate care. It would be absurd to suggest that a committee engaged in medical study should be limited to the cases of dead people or healthy people. It would also defeat the humanitarian purposes of I.C. § 39-1392 if the committee’s statutory protection were deemed to cease whenever its medical study gave rise to a recommendation for proper patient care.
However, the problem of the phantom consultant remains. I believe the solution in future cases lies not in narrowing § 39-1392 by judicial construction, as we were asked to do here. Rather, the problem should be addressed directly by modifying the local standard which treats the committee as a substitute consultant. In my view, no local standard should accord a committee consultation the weight of a second opinion unless all parties — the patient, his doctor, and the committee itself — unanimously agree in advance to full disclosure of committee proceedings concerning that patient, If the committee will not so agree — thereby signifying its unwillingness to take on the responsibilities of a genuine consultant— the case might still be submitted to the committee for educational purposes. But the doctor and his patient should obtain any required second opinion from a qualified, consulting physician. On the other hand, if the committee does agree to full disclosure, it should further inform both doctor and patient whether it intends to claim any protection from liability under the immunity statute. This procedure would minimize or avoid the kind of misunderstandings among the doctor, the patient and the committee that have spawned the appeal in the instant case.