Schrader v. Kohout

Eldridge, Judge,

dissenting.

I respectfully dissent.

In her professional capacity as a psychologist, and for compensation, the defendant rendered professional advice, counsel, evaluation, assistance, and insight into the care, treatment, and evaluation of the plaintiff continuously for over four and one-half years. She knew or should have known that her advice and professional counsel would have an effect on the treatment of the plaintiff. While defendant did not know the identity of the plaintiff, defendant knew that she had an influence and effect through her professional advice upon the treatment of a real person, the plaintiff. Defendant, through the bimonthly consultations for compensation, participated in the treatment of the plaintiff vicariously, through Dr. Ulrici.

Where a professional for compensation provides consultations regarding the care and treatment of a specific individual, a patient-psychologist relationship has been legally created with such individual, so that a malpractice action may be maintained, even though there has been no direct contact or examination of the records, reports, or tests. “Where the consultant physician does not physically examine or bill the patient, a physician-patient relationship can still arise where the physician is contractually obligated to provide assis*139tance in the patient’s diagnosis or treatment and does so.” (Citation omitted.) Corbet v. McKinney, 980 SW2d 166, 169 (Mo. App. 1998).

A physician-patient relationship is created by implication between a patient and an on-call physician, who is consulted by the patient’s physician but who has never met or consulted with either the other physician or his patient previously, when the on-call physician “(1) participates in the diagnosis of the patient’s condition, (2) participates in or prescribes a course of treatment for the patient, and (3) owes a duty to the hospital, staff, or patient for whose benefit he is on call.” McKinney v. Schlatter, 118 Ohio App.3d 328 (692 NE2d 1045, 1050) (1997).

When a physician consults at the request of another physician without seeing the patient face to face, as in the case of a pathologist, radiologist, or other specialist, an implied consent results. “The important fact in determining whether the relationship is a consensual one, however, is not who contracted for the service but whether it was contracted for with the express or implied consent of the patient or for his benefit.” Walters v. Rinker, 520 NE2d 468, 472 (Ind. App. 1988); accord Bovara v. St. Francis Hosp., 298 111. App.3d 1025 (700 NE2d 143) (1998); Dougherty v. Gifford, 826 SW2d 668, 674-675 (Tex. App. 1992); Peterson v. St. Cloud Hosp., 460 NW2d 635 (Minn. App. 1990); Phillips v. Good Samaritan Hosp., 65 Ohio App.2d 112 (416 NE2d 646) (1979).

A casual consultation, even when it directs a course of treatment, does not give rise to a physician-patient relationship, because the elements of implied physician-patient relationship are absent. Minster v. Pohl, 206 Ga. App. 617, 620 (2) (426 SE2d 204) (1992); accord Oja v. Kin, 229 Mich. App. 184 (581 NW2d 739) (1998); Oliver v. Brock, 342 S2d 1 (Ala. 1977); Lopez v. Aziz, 852 SW2d 303, 306 (Tex. App. 1993); Flynn v. Bausch, 238 Neb. 61, 67 (469 NW2d 125) (1991); Hill v. Kokosky, 186 Mich. App. 300 (463 NW2d 265) (1990); Sullenger v. Setco Northwest, 74 Ore. App. 345 (702 P2d 1139) (1985).

It is a well-settled principle of Georgia law that there can be no liability for malpractice in the absence of the health care provider-patient relationship. There are three essential elements imposing liability upon which recovery is bottomed [(and only the first is relevant here)]: (1) The duty inherent in the health care provider-patient relationship. . . . [H]ealth care provider-patient privity is essential because it is this relation which is a result of a consensual transaction that establishes the legal duty to conform to a standard of conduct. The relationship is considered consensual where the patient knowingly seeks the assistance of the health care provider and the health care provider knowingly *140accepts him as a patient. . . . Peace v. Weisman, 186 Ga. App. 697, 698 (1) (368 SE2d 319) (1988).

(Citations and punctuation omitted.) South Fulton Med. Center v. Poe, 224 Ga. App. 107, 109 (480 SE2d 40) (1996); see also Butters-worth v. Swint, 53 Ga. App. 602, 603 (2) (186 SE 770) (1936).

[I]t has been held almost uniformly in other jurisdictions that a physician who has been retained by a third party [, who is neither the treating physician nor acting on behalf of the patient,] to undertake a medical examination of an individual cannot be held liable to that individual for malpractice as a result of that examination, where he neither offered nor intended to treat, care for, or otherwise benefit the individual and did not injure him during the course of the examination. [Cits.] A different result is, of course, mandated where the physician did assume the role of treating the patient. [Cits.]

(Emphasis supplied.) Peace v. Weisman, supra at 698-699.

A [psychologist]-patient relationship exists where the patient [or someone on her behalf] knowingly seeks the assistance of the [psychologist] and the [psychologist] knowingly accepts [her] as a patient. We have held in medical malpractice actions, and it is generally the law of other jurisdictions, that when an employer retains a physician to examine an employee, no physician-patient relationship exists between the employee and the physician. This is because in such a situation, the physician has neither offered nor intended to treat, care for, or otherwise benefit the individual.

(Citations and punctuation omitted; emphasis supplied.) Payne v. ' Sherrer, 217 Ga. App. 761, 762-763 (1) (458 SE2d 916) (1995). Consultation for a fee with the treating professional, regarding the diagnosis, care, and treatment of a subject individual, creates a professional-client relationship with such subject individual.

Under the facts and circumstances of this case, defendant knowingly, intentionally, and willingly entered into and undertook to provide consultations for Kohout for compensation, waiving any right to know her identity, to examine either Kohout or her records, or to be more directly involved in her treatment for over four and one-half years. This is not a case of a quick, free, casual consultation between colleagues, but a long-term professional relationship for a fee regarding the care and treatment of the plaintiff. See generally Minster v. *141Pohl, supra at 620-621 (2). Although “there is no rule of law that requires a physician to undertake the treatment of every patient who applies to him,” when, as in this case, a defendant undertakes for compensation to consult on the care of a patient for four and one-half years, such undisputed facts and circumstances create a professional relationship and duty of care. Buttersworth v. Swint, supra at 604; accord Clanton v. Von Haam, 177 Ga. App. 694, 696-697 (2) (340 SE2d 627) (1986). Thus, defendant “knowingly accepted] [Kim] as a [consultation] patient,” even though she did not intend to create a legal relationship as psychologist-patient; by undertaking intentionally to act as a consultant in the care and treatment of the plaintiff, the defendant created the legal relationship of psychologist-patient. See generally South Fulton Med. Center v. Poe, supra at 109.

While the plaintiff was not aware that the defendant was consulting with Dr. Ulrici, plaintiff, through her patient-psychologist relationship with Dr. Ulrici, had authorized and empowered Dr. Ulrici to associate or consult with anyone during her treatment that Dr. Ulrici deemed appropriate for plaintiff’s care and treatment. Thus, Dr. Ulrici had the power and authority to create and accept on plaintiff’s behalf the patient-psychologist relationship with the defendant, which she did. The four and one-half years of compensated consultation with defendant had one single purpose, the care and treatment of plaintiff. Whether viewed as a third-party beneficiary to the agreement between the professionals or a contract by an agent, Dr. Ulrici, on behalf of a principal (plaintiff), expended considerable time and money with the defendant so that the defendant could have an effect on the plaintiff’s treatment, and defendant intentionally continued in such arrangement. South Fulton Med. Center v. Poe, supra at 109-110. This is not a case where the plaintiff rejected the care and treatment of the defendant, but in fact accepted it, albeit vicariously, through Dr. Ulrici. See Clough v. Lively, 193 Ga. App. 286, 288 (387 SE2d 573) (1989). The trial court did not err in denying the motion for summary judgment.

As a matter of public policy, a professional should not be permitted to profit monetarily and experientially from professional consultation regarding the care and treatment of a patient, and still escape the duty to exercise ordinary care as a professional for such patient. Otherwise, a professional could indirectly through consultations use humans as guinea pigs upon whom to experiment without incurring liability.4

*142Decided July 15, 1999 Smith, Gambrell & Russell, Rex M. Lamb III, Edward D. Burch, Jr., for appellant. Goetz, Tibbs & Zahler, Charles M. Goetz, Jr., Philippa V. Tibbs, Scott M. Zahler, for appellee. Rogers & Hardin, Robert B. Remar, amicus curiae.

I am authorized to state that Presiding Judge Pope joins in this dissent.

Where a physician or other health care professional undertakes to train and supervise, as faculty, staff, or contract provider, other members of their profession as part of an ongoing training program involving the care and treatment of patients, “in the increasingly complex modern delivery of health care, a physician who undertakes to provide .. . supervi*142sion of residents [or other professionals in training] actually treating a patient may be held accountable to that patient, if the physician negligently supervises those residents [or other professionals in training] and such negligent supervision proximately causes the patient’s injuries,” then the supervising physician or health care professional is liable to the patient, notwithstanding the absence of a physician-patient relationship. (Citations omitted.) Moz-ingo v. Pitt County Mem. Hosp., 331N. C. 182 (415 SE2d 341, 345) (1992); see also Jackson v. Oklahoma Mem. Hosp., 909 P2d 765 (Okla. 1996); Brooks v. Goldhammer, 608 S2d 394 (Ala. 1992). The supervising physician or health care professional owes to the patient a duty of ordinary care in the supervising of the training of others. Rouse v. Pitt County Mem. Hosp., 343 N. C. 186 (470 SE2d 44, 47) (1996).

Under the facts of this case, the defendant denies that she undertook to supervise Dr. Ulrici or others. However, the existing evidence raises a strong inference that the defendant may have, in fact, been supervising Dr. Ulrici. Further, discovery and evidence could establish whether or not which was the case or show that there exists a clear disputed material issue of fact in such regard.