Court Opinion

ID: 9670289
Source: CourtListenerOpinion
Date Created: 2023-08-24 03:18:17.257018+00
Date Added: 2024-06-11T18:16:03.649026
License: Public Domain

JANINE P. GESKE, J.
(concurring). Although I agree with the mandate of the court, I write separately to emphasize that State ex rel. Klieger v. Alby, 125 Wis. *4802d 468, 373 N.W.2d 57 (Ct. App. 1985), erroneously-concluded that the physician-patient privilege is not waived upon commencement of a lawsuit. The rule prohibiting ex parte communications between an attorney and an opposing party's physician regarding the medical information of the opposing party must be based upon public policy considerations and not upon the discovery rules under ch. 804, Stats., or the rules of evidence under ch. 905, Stats.
In Klieger, a medical malpractice case, the court of appeals stated that there is "no case law to support the notion that a statutory physician-patient privilege is waived on commencement of a lawsuit so as to allow informal conferences with treating physicians, unless the privilege is lost due to unrelated exceptions." Klieger, 125 Wis. 2d at 473. In reaching this conclusion, the court of appeals considered whether the circuit court erred when it refused to prohibit the attorneys for the defendant-physician and the hospital from informally consulting the plaintiffs treating doctor about the case. Specifically, the court of appeals analyzed whether the exception provided in § 905.04(4)(c), Stats., allowed such "informal discovery." Id. The court concluded that the statutory exception to the physician-patient privilege did not cover informal discussion, reasoning that the scope of the exception is limited to evidence which is uncovered only through statutorily permitted methods of discovery, such as oral or written depositions and interrogatories. In particular, the court of appeals relied upon the following language in § 905.04(4)(c): "There is no privilege ... as to communications relevant to or within the scope of discovery . . .."In other words, a patient-litigant does not waive the physician-patient privilege with regard *481to any evidence that is outside the scope of formal discovery.
I believe the court of appeals in Klieger misinterpreted § 905.04(4)(c). The statute does not create an exception to the privilege only within the scope of formal discovery. Clearly, once a patient-litigant puts his or her physical, mental, or emotional condition into issue in a lawsuit, any confidential physician-patient communications relating to that issue, including those relevant to discovery under ch. 804, Stats., are not privileged.
Despite the filing of a lawsuit, the patient-litigant, in fact, retains the right to expect that his or her treating physician will only release the information that is relevant to the issues in the litigation. The physician-patient relationship is premised upon confidentiality. The Hippocratic Oath, the American Medical Association's Principles of Medical Ethics, and the Current Opinions of the Judicial Council of the American Medical Association define the physician's ethical responsibilities regarding confidentiality. See Petrillo v. Syntex Laboratories, Inc., 499 N.E.2d 952, 957 (Ill. App. Ct. 1986). These three ethical sources all highlight "the highly confidential nature of the physician-patient relationship . . .."Id. A doctor who discloses confidential patient information in the course of a conversation may be exposing himself or herself to liability for a common law tort for breach of that confidential relationship. Physicians, like attorneys, must adhere to their profession's ethical rules regarding the preservation of patient confidentiality.
When, as in Klieger, a defense attorney desires to talk informally to a treating doctor outside the presence of the patient-litigant, there is a substantial risk that the conversation will wander outside the medical *482information "relevant to or within the scope of discovery examination of an issue of the physical, mental or emotional condition of a patient," § 905.04(4)(c), Stats., and into medical information that is still privileged under both § 904.04(2) and the general rules of physician-patient confidentiality. Since neither the patient-litigant nor his or her attorney is present, they are unable to protect against the disclosure of the confidential and privileged information. In filing a lawsuit, a patient-litigant waives the privilege and confidentiality only as to some information, but "does not automatically consent to the termination of the confidential relationship existing between [the patient] and ... physician." Petrillo, 449 N.E.2d at 959.1
In order to protect the confidentiality of a patient-litigant, I believe that public policy requires a prohibition of ex parte communications between the opposing attorney and the patient-litigant's treating physician about confidential medical information. This prohibition, however, does not compel the conclusion that opposing counsel should be prohibited from all ex parte communications with the patient-litigant's treating physician. Not all ex parte communications imperil the sanctity of the confidential relationship. As the majority notes, opposing counsel should be able to communicate ex parte with a patient-litigant's treating physicians for the purpose of discussing scheduling or procedural matters or even to tell a physician that he or she may be joined as a party to the lawsuit. Majority op. at 469; see, e.g., Haack v. Temple, 150 Wis. 2d 709, 718, 442 N.W.2d 522 (Ct. App. 1989) (conversations which discuss the mechanics of a deposition are permissible). Attorneys who do choose to talk to a treating *483physician outside the presence of the patient-litigant must take great care not to allow the conversation to include confidential information.
The majority correctly holds that defense counsel may communicate ex parte with a patient-litigant's treating physician so long as the communication does not involve the disclosure or discussion of confidential information and so long as the physician is not represented by counsel. Majority op. at 469. This holding permits appropriate nonconfidential communications between defendant's attorney and plaintiffs treating physician. Ex parte communications which are prohibited by the rule because they undermine the sanctity of the physician-patient relationship must, therefore, be clearly distinguished from those which are permitted because they do not disclose confidential information.
I am authorized to state that Chief Justice Nathan S. Heffeenan and Justice Shirley S. Abrahamson join this concurring opinion.

 I note here that this court does not adopt the rule stated in Petrillo.