Gibson v. Bronson Methodist Hospital

Griffin, J.

I respectfully dissent. I would affirm and adhere to the Court of Appeals interpretation of the relevant court rules, which more accurately reflects the purpose of the physician-patient privilege.

In Domako v Rowe, 438 Mich 347; 475 NW2d 30 (1991), this Court held that an ex parte interview of the plaintiff’s treating physician by defense counsel in a medical malpractice action is proper where the physician-patient privilege has been waived by lack of timely assertion. In addressing the parameters of discovery in the context of waiver this Court reiterated the underlying rationale of the physician-patient privilege:

Unlike other forms of litigation, a case involving *341medical malpractice cannot proceed without evidence of the physical or mental condition of the plaintiff. Therefore, requiring the plaintiff to decide whether to assert the privilege at the discovery stage, rather than at trial, promotes efficient use of judicial resources by fostering an early resolution of this issue.
The purpose behind the physician-patient privilege is to protect the confidential nature of the physician-patient relationship and to encourage the patient to make a full disclosure of symptoms and conditions. [Citations omitted.] The purpose of providing for waiver is to prevent the suppression of evidence. . . . An attempt to use the privilege to control the timing of the release of information exceeds the purpose of the privilege and begins to erode the purpose of waiver by repressing evidence. Both consequences are anathema to the open discovery policy of our state. [Domako, supra, pp 354-355.]

The all-or-nothing nature of the privilege was underscored by the Domako Court:

After the patient voluntarily allows discovery of the medical information, the plaintiff is not thereafter free to assert the privilege because the plain language of MCR 2.314(B)(1) declares that the privilege is waived for that action. The rule is a logical one; after filing a malpractice action and authorizing the release of medical information, the plaintiff can no longer claim an intent to preserve the sanctity of the physician-patient privilege. The privilege attempts to protect confidentiality, and the voluntary disclosure of the information takes away the need for confidentiality. The court correctly determined that the privilege had been waived. [Id., p 357. Emphasis in original.]

In the instant case, the trial court, by applying the sanctions set forth in MCR 2.314(B)(2) to dismiss plaintiff’s suit, acted not only within its *342discretion but also in a manner consistent with the principles recognized in Domako.

MCR 2.314(B) provides:

(1) A party who has a valid privilege may assert the privilege and prevent discovery of medical information relating to his or her mental or physical condition. The privilege must be asserted in the party’s written response under MCR 2.310. A privilege not timely asserted is waived in that action, but is not waived for the purposes of any other action.
(2) Unless the court orders otherwise, if a party asserts that the medical information is subject to a privilege and the assertion has the effect of preventing discovery of medical information otherwise discoverable under MCR 2.302(B), the party may not thereafter present or introduce any physical, documentary, or testimonial evidence relating to the party’s medical history or mental or physical condition. [Emphasis added.]

MCR 2.302(B)(1)(b) addresses the assertion of a privilege in the context of a deposition.

A party who has a privilege regarding part or all of the testimony of a deponent must either assert the privilege at the deposition or lose the privilege as to that testimony for purposes of the action. A party who claims a privilege at a deposition may not at the trial offer the testimony of the deponent pertaining to the evidence objected to at the deposition.

The question before the Court is whether the sanction set forth in MCR 2.314(B)(2) applies when a party asserts the physician-patient privilege in the context of a deposition seeking medical information. The majority, relying on the reference in this court rule to MCR 2.310, concludes that the *343sanction applies only where a party asserts the privilege in response to a request for production of documents under MCR 2.310. The majority maintains that "MCR 2.314 clearly contemplates the discovery of documentary or tangible medical information rather than testimonial medical information.” Ante, p 336. The appropriate sanction under these circumstances would, according to the majority, be merely to exclude the physician from testifying at trial, rather than preventing plaintiff from introducing any evidence of her medical condition.

However, this conclusion is contradicted by the language of MCR 2.314. Section (A)(2) contains a broad definition of "[m]edical information subject to discovery,” which "includes, but is not limited to, medical records in the possession or control of a physician, hospital, or other custodian.” (Emphasis added.) Moreover, the penalty provision of MCR 2.314(B)(2) specifically refers to "medical information otherwise discoverable under MCR 2.302(B),” which certainly would include the knowledge of a physician that he might give at a deposition. It is likewise notable that MCR 2.314(E) specifically allows the discovery of medical information, and assertion of the privilege, by means of deposition.*

Significantly, the first phrase of MCR 2.314(B)(2), which begins "Unless the court orders otherwise,” implies discretion in the trial judge to choose between the sanctions set forth in subsection (B)(2) or other penalty provisions set forth in the court *344rules, such as the assessment of costs and attorney fees pursuant to MCR 2.306. Consequently, assertion of the privilege at the depositions at issue could, as the trial court and Court of Appeals concluded, result in the appropriate invocation of the penalty provision of MCR 2.314(B)(2). The trial court in the case at hand acted within its discretion in dismissing the case.

The majority overlooks the fact that the court rules were written with many types of privileges in mind. Although the interpretation given by the majority might be appropriate in cases involving other privileges recognized under the law, it should be recognized that MCR 2.314 is the only court rule that is specifically tailored for situations involving privileged medical information. This particularized court rule exists for good reason — as noted above, the physician-patient privilege is not susceptible to piecemeal application. As explained by McCormick in his treatise on 1 Evidence (4th ed), § 103, p 384:

A shrinking from the embarrassment which comes from exposure of " bodily disease or abnormality is human and natural. It is arguable that legal protection from exposure is justified to encourage frankness in consulting physicians. But it is not human, natural, or understandable to claim protection from exposure by asserting a privilege for communications to doctors at the very same time when the patient is parading before the public the mental or physical condition as to which he consulted the doctor by bringing an action for damages arising from that same condition. This, in the oft-repeated phrase, is to make the privilege not a shield only, but a sword.

The trial court’s decision to preclude further evidence of plaintiff’s physical condition is a natu*345ral corollary to the principle set forth in Domako, supra, that once a plaintiff allows discovery of medical information, he is not thereafter free to assert the privilege in that action. A plaintiff either must allow free discovery of medical information otherwise subject to the privilege or assert the privilege at the expense of forgoing any claims concerning plaintiff’s medical condition. Piecemeal use of privileged testimony or material would detrimentally increase the recognized tension between preserving the confidentiality of the physician-patient relationship and the truth-seeking function of the courts. Domako, supra, pp 356-357.

Defendants in their appellate brief express the legitimate fear that

[a] clever plaintiff’s attorney could assert privilege at the deposition of a treating physician, whom plaintiff does not want to testify, and thereby frustrate a defendant’s attempt to discover the true nature of the plaintiff’s injury or condition. According to the plaintiff, the only sanction for invoking the privilege in this fashion would be that the plaintiff could not later offer at trial the testimony of that particular physician. As already noted, however, in a case where the plaintiff wants to prevent that particular physician from testifying in the first place, the sanction provided by MCR 2.302(B)(1)(b) would be a meaningless sanction. [Emphasis in original.]

Any attempt to use the privilege to manipulate the timing of the information and achieve a tactical advantage exceeds the scope of the privilege. Domako, supra. The majority’s rendition of the court rules in the case at hand reopens the door to abuse of the privilege that had been so purposefully closed in Domako, supra.

*346I would affirm the decision of the Court of Appeals upholding summary disposition in favor of defendants.

Cavanagh, C.J., concurred with Griffin, J.

MCR 2.314(E) provides:

(1) This rule does not prevent the discovery of medical information in proceedings under MCR 2.306 [governing depositions] or other provisions of these rules.
(2) This rule does not prevent the assertion of a privilege at a time or in a manner otherwise permitted by these rules.