M. v. State Board of Medicine

JIULIANTE, Senior Judge,

dissenting.

I respectfully dissent. I disagree with the Majority’s conclusion that C.D.’s agreement to be evaluated by Dr. Badgio only for purposes of the federal civil action constituted a complete waiver of confidentiality regarding the results of that evaluation for purposes of any proceeding, including the Bureau’s disciplinary proceeding before the Board against Dr. M. As acknowledged by the Majority, it was C.D.’s understanding that Dr. Badgio was a neutral person coming in for purposes of the “federal civil suit only” to do psychological testing to determine the possibility of damages related to C.D.’s therapeutic experiences with Dr. M, and that the results of Dr. Badgio’s evaluation were to be used for the civil suit only, as reflected by C.D.’s motion for protective order, wherein he stated:

I wish to file a motion for protective order objecting to the disclosure of any information (medical records, reports and testimony) by Peter Badgio, Ph.D. as it applies to Docket No. 0638-49-67, File No. 93^9-03892, Court of Pennsylvania Bureau of Professional Affairs v. [Dr. M], respondent.
I agreed to an evaluation by Peter Badgio only for the purpose of determining damages during discovery of the federal civil action suit against [Dr. M]. The evaluation *1270was agreed upon to be used for no other purpose than the civil lawsuit.
In addition, when I initially agreed to testing, I was under the impression that Peter Badgio was a neutral examiner with no relationship to myself or to [Dr. MJ. I had since learned that Peter Badgio was at one time during his training a student of [Dr. M’s]. If this information were revealed to me prior to my meeting with him, I would not have agreed to an evaluation by Dr. Badgio in that he misrepresented himself as a neutral third party.
I also object to the idea of introducing the results of psychological testing conducted in June of 1995 during a period of severe emotional distress (discovery and deposition for the civil case) and attempting to apply the results to “therapy” that was conducted from 1991 through 1993. This psychological evaluation was conducted greater than four years after I had my first encounter with [Dr. M] and should not be used to speculate on issues related to the current case before the Board ....

(C.D.’s July 20, 1998 Motion for Protective Order; R.R. 161a) (emphasis added). As reflected by his motion for protective order, C.D. did not agree to permit Dr. Badgio to testify regarding his evaluation of him in the Bureau’s disciplinary proceeding against Dr. M before the Board. Section 9(c) of the Medical Practice Act of 1985,1 relating to the subpoena power of the Board in disciplinary proceedings, provides in part:

The board shall have the authority to issue subpoenas, upon application of an attorney responsible for representing the Commonwealth in disciplinary matters before the board, for the purpose of investigating alleged violations of the disciplinary provisions administered by the board. The board shall have the power to subpoena witnesses, to administer oaths, to examine witnesses, and to take testimony or compel the production of books, records, papers and documents as it may deem necessary or proper in and pertinent to any proceeding, investigation or hearing held by it. Medical records may not be subpoenaed without consent of the patient or without order of a court of competent jurisdiction on a showing that the records are reasonably necessary for the conduct of the investigation. The court may impose such limitations on the scope of the subpoena as are necessary to prevent unnecessary intrusion into patient confidential information_ (Emphasis added.)

Despite the language of Section 9(c) requiring a showing that the records are reasonably necessary for the conduct of the investigation, the Majority would require the Board to compel Dr. Badgio to testify, without limitation, concerning C.D.’s mental state, even without a showing such evidence is relevant, on the ground that C.D. has no expectation of privacy at all regarding that information for purposes of any legal proceeding whatsoever. The Majority disregards the fact that C.D. never agreed to be examined by Dr. Badgio for the purposes of the Bureau’s disciplinary proceeding against Dr. M.

Moreover, unlike the appellant-mothers in either Adoption of Embick, 351 Pa.Super. 491, 506 A.2d 455 (1986), petition for allowance of appeal denied, 513 Pa. 634, 520 A.2d 1385 (1987), or In the Interest of Bender, 366 Pa.Super. 450, 531 A.2d 504 (1987), two cases heavily relied by the Majority for the proposition that C.D. has no expectation of privacy

at all in any proceeding because of his alleged agreement to be examined for the limited purposes of the federal civil action, C.D. is not a party to the disciplinary proceeding in the ease at bar, and the state agency prosecuting Dr. M has not requested that C.D. be examined by Dr. Badgio for any reason. Consequently, I disagree with the Majority that C.D.’s agreement to be examined for the limited purposes of the federal civil action should permit Dr. M to compel Dr. Badgio to testify in the disciplinary proceeding before the Board as to the results of such an examination absent a showing that such information is relevant and necessary as required by Section 9(c) of the Medical Malpractice Act of 1985, regardless of whether a “client” or “patient” relationship existed between Dr. Badgio and C.D.

*1271In summary, I believe that the parties could agree to a limited waiver of confidentiality and that C.D. had a reasonable expectation that Dr. Badgio’s testimony regarding his evaluation of him would not be presented outside the federal civil action. Moreover, even assuming no psychotherapist-patient relationship existed between C.D. and Dr. Bad-gio, rather than reversing the Board’s order granting C.D.’s protective order, I would, pursuant to Section 9(c) of the Medical Malpractice Act of 1985, vacate said order and remand this matter to the Board for a determination as to whether Dr. Badgio’s testimony is in fact relevant and reasonably necessary in the disciplinary proceeding.2 If the Board determines that such information is not relevant or necessary for the purposes of the investigation, C.D. should be entitled a protective order.

. Act of December 20, 1985, P.L. 457, 63 P.S. § 422.9.

. The parties appear to dispute whether Dr. Bad-gio’s testimony regarding C.D.'s mental state is relevant for purposes of the disciplinary proceeding. At the hearing, the Bureau presented, inter alia, the testimony of Robert M. Wettstein, M.D., a psychiatrist who specializes in psychiatric and medical ethics and psychiatric/legal issues. Dr. Wettstein testified, within a reasonable degree of medical certainty, that the duty and responsibility for maintaining professional boundaries and ethics in psychotherapeutic settings is always on the treatment provider no matter how mentally unstable the patient is or what the patient would like to do. (N.T. 119-120; R.R. 58a-59a). Dr. Wettstein further testified that he was familiar with Dr. M’s treatment of C.D., i.e., undressing and permitting C.D. to perform rectal and genital examinations on him, and that such treatment was objectively unprofessional. (N.T. 121-123; R.R. 60a-62a). In response, Dr. M presented the testimony of three psychotherapists, Harvey Schwartz, M.D., Bradley M. Sevin, M.D., and Homer C. Curtis, M.D., who testified that Dr. M’s treatment of C.D. was appropriate under the circumstances. (N.T. 333-334, 341-346, 351, 406, 452-454, 459-459; R.R. 87a-96a, 104a, 116a-118a, 120a-123a). Given its expertise, I believe that the Board would be in the best position to determine whether Dr. Badgio’s testimony is relevant.