Court Opinion

ID: 9612339
Source: CourtListenerOpinion
Date Created: 2023-08-22 04:07:23.630911+00
Date Added: 2024-06-11T18:03:20.582255
License: Public Domain

EDMONDS, J., Dissenting.
This case presents only two questions for decision: (1) Does the plan followed by the *162appellant in providing health service for its contract holders violate the provisions of the Medical Practice Act, and (2) If not, is its plan violative of public policy? I find nothing in the act which expressly or by implication prohibits a corporation from hiring a physician regularly licensed to practice in this state to care for its employees or members, and I see no reason for holding that the plan contravenes public policy.
The decision to the contrary relies upon the cases of Painless Parker v. Board of Dental Examiners, 216 Cal. 285 [14 Pac. (2d) 67], People v. Merchant’s Protective Corp., 189 Cal. 531 [209 Pac. 363], Pacific Employers Ins. Co. v. Carpenter, 10 Cal. App. (2d) 592 [52 Pac. (2d) 992], and Benjamin Franklin L. Assn. Co. v. Mitchell, 14 Cal. App. (2d) 654 [58 Pac. (2d) 984], The two appellate court decisions are directly in point in support of respondent’s position. The opinions in those cases clearly hold that a health insurance plan similar to that involved in the present ease is violative of the Medical Practice Act and of public policy, in that it contemplates and provides for the practice of medicine by a corporation, although it may be noted that the Benjamin Franklin case was decided by a divided court. The Painless Parker case involved the unlawful practice of dentistry by a corporation in violation of the Dental Practice Act, a statute substantially different from the Medical Practice Act in that it expressly prohibited the practices there involved. There can be no doubt, and appellant concedes, that within certain constitutional limitations the legislature may declare that the employment of physicians by lay persons or corporations constitutes the practice of medicine. The Dental Practice Act did so declare. The Medical Practice Act contains no such provision, and the appellant expressly excludes dental care from its contracts.
The Merchant’s Protective Corporation case, supra, is likewise not controlling. The evidence in that case showed that the corporation contracted to hire attorneys to render legal advice to members of the corporation. It attempted to justify its action, according to the opinion of the court, upon the ground that “it is merely an agency for the bringing of attorneys and clients together and is not itself engaged in practicing law.’ ’ It was held that this contention was not supported by the facts in that under its articles and contracts the eorpo*163ration itself, through attorneys, purported to give legal advice. The implication of the opinion is that if the corporation were in fact an agency which for a fee brought attorneys and clients together, its activities would have been within the law.
The present case involves a factual and legal situation fundamentally different from the contract for legal services. Here the corporation is acting as an agency for bringing the doctor and patient together. In addition it underwrites or insures the cost of such medical care. The doctor in caring for the insured is not rendering medical care on behalf of the corporation. When the doctor starts treatment of the member, the relationship of doctor and patient, with all that such a relationship implies, is created. The situation is legally no different from that where A (who may be a layman or a corporation) secures medical services for B from C, a duly licensed physician, C agreeing to look solely to A for his fee. Could it be successfully contended that A is practicing medicine? I think not. As I read the articles of incorporation and the contracts here involved the corporation does not directly or indirectly agree to perform any medical service; it merely agrees to pay for it when rendered by persons duly licensed to render it. It is true that the member does not have unlimited choice in the selection of a doctor, and that he must select a physician approved by the corporation. But there is nothing in the stipulated facts indicating that the corporation directly or indirectly supervises the doctors in the professional service rendered the member.
There are cases in this state and elsewhere recognizing that, in the absence of a statute providing to the contrary, a corporation or a layman may lawfully employ a doctor to care for its patrons or members. These cases hold that practices substantially similar to those here involved do not constitute the unlawful practice of medicine. In Renwick v. Phillips, 204 Cal. 349 [268 Pac. 368], it was held that a storekeeper may employ a person licensed under the Medical Practice Act to treat his patrons. In that ease the Board of Medical Examiners had revoked the license of Dr. Ben-wick upon the ground that he had aided and abetted one Boy Finney, a lay person, to practice medicine. This court stated: “The petitioner (Benwick) was a licensed chiropodist. The said Boy Finney conducted a chiropodist parlor, *164equipped with a variety of foot remedies and appliances which he prepared and sold there. He employed the petitioner and respondent herein to act as a chiropodist in connection with his said establishment and to give such treatment and perform such operations as only could be done by the holder of a regular chiropodist’s license so to do. In so far there teas nothing illegal or unprofessional in the relations or conduct of Dr. Renwick in his connection with said Finney at the latter’s place of lousiness. ...” This decision was written by Justice Richards, who six years before had written the opinion in the Merchant’s Protective Corporation case, supra. In Pilger v. City of Paris Dry Goods Co., 86 Cal. App. 277 [261 Pac. 328], it was held that “there can be no doubt that a corporation may undertake to furnish the services of a competent physician or the services of a competent chiropodist”. In State Electro-Medical Institute v. State, 74 Neb. 40 [103 N. W. 1078, 12 Ann. Cas. 673], the Supreme Court of Nebraska held that although a corporation may not practice medicine, it may contract with its members to furnish them with medical care. The court stated: “The intention of the law is that one who undertakes to judge the nature of a disease, or to determine the proper remedy therefor, or to apply the remedy, must have certain personal qualifications; and, if he does these things without having complied with the law, he is subject to its penalties. Making contracts is not practicing medicine. Collecting the compensation' therefor is not practicing medicine, within the meaning of this statute. No professional qualifications are requisite for doing these things.” See, also, State ElectroMedical Institute v. Platner, 74 Neb. 23 [103 N. W. 1079, 121 Am. St. Rep. 706]; State v. Lewin, 128 Mo. App. 149 [106 S. W. 581],
Respondent and amici curiae appearing on its behalf, urge that the plan of the appellant violates public policy. But if the policy were as contended by respondent it would be clearly stated in the pertinent statutes. This the legislature has not seen fit to do. In recent years the subjects of health insurance and group medicine have been the frequent source of discussion and investigation, and both lay and professional opinion concerning them is sharply divided. The need for some such service, particularly for persons of low income, is conceded by all parties to the controversy. The courts, *165in the absence of legislation, should not on the ground of public policy place a stumbling-block in the way of working out this problem. It is not a proper function of the courts to thus block the natural growth of social and economic processes.
The attempt of lay associations or corporations to retain doctors for the purpose of rendering medical services to their members in return for the payment of dues or a premium is by no means a modern development. Judicial notice can be taken that for many years fraternal, employee, and hospital associations, and various medical-hospital services have been rendering such services to their members through doctors employed by them. Respondent does not question the propriety of their activities. If this court holds that the plan adopted by appellant is unlawful on the ground urged by respondent, that is, that it permits a corporation to unlawfully practice medicine, it inevitably and necessarily follows that all of such associations are likewise unlawfully practicing medicine. Such a conclusion, adversely affecting the interests of thousands of individuals, should only be reached if compelled by statutory enactment or by clear public policy. Neither is present in the instant case.
It is claimed that the medical profession will be commercially exploited if private corporations interested solely in a profit are permitted to engage in activities such as are here involved. If that is an evil the solution rests with the legislature and not with the courts. It may be added that under the Workmen’s Compensation Act insurance companies through doctors employed by them are daily rendering-medical service to thousands of injured employees, to the apparent satisfaction of all concerned.
The judgment should be reversed.
Waste, C. J., and Houser, J., concurred.
Rehearing denied. Edmonds, J., and Houser, J., voted for a rehearing.