§47.24 Existence of Physician – Patient Relationship

The Case: Kelley v. Middle Tenn. Emergency Physicians , 133 S.W.3d 587 (Tenn. 2004).

The Basic Facts: Plaintiffs were the surviving spouse and children of a woman who died for a heart condition after being seen by a number of physicians at several hospitals. Plaintiffs subsequently filed a malpractice suit against numerous defendants.

The Bottom Line:

• "We granted review to determine whether the trial court erred in granting summary judgment to the defendants in this medical malpractice lawsuit. The trial court concluded that there was no genuine issue of material fact and that, as a matter of law, no physician-patient relationship existed. The Court of Appeals reversed the judgment of the trial court. After careful review of the record before us and the applicable authorities, we conclude that there are disputed issues of fact as to the existence of a physician-patient relationship, and we therefore affirm the decision of the Court of Appeals." 133 S.W.3d at 588-89.
• "The Medical Malpractice Act^FN7 does not explicitly require the plaintiff to prove that the defendant owed the plaintiff a duty of care. However, as we previously have stated, the Act 'codifies the common law elements of negligence-duty, breach of duty, causation, proximate cause, and damages. No claim for negligence can succeed in the absence of any one of these elements.' Kilpatrick, 868 S.W.2d at 598 (citations omitted); see also Gunter v. Lab. Corp. of Am., 121 S.W.3d 636, 639-40 (Tenn. 2003); Burroughs v. Magee, [118 S.W.3d 323, 327-28 (Tenn. 2003), reh'g denied (Oct. 28, 2003)]. The question of whether the plaintiff in a medical malpractice action must prove the existence of a physician-patient relationship relates to the first element of negligence-i.e., whether the defendant-physician owed a duty of care to the plaintiff.

  FN7 Tennessee's medical malpractice statute was originally titled the 'Medical Malpractice Review Board and Claims Act of 1975.' However, when sections 29-26-101 to 29-26-114 were repealed in 1985, the title was repealed, and no new title was substituted. For ease of reference, we now refer to the statute as the 'Medical Malpractice Act.'"

  Id. at 592.
• "Under the foregoing cases, a physician's duty of care arises from the physician-patient relationship.^FN9 We next consider the circumstances under which such a relationship is established.

  FN9 The plaintiff asserts that the existence of a physician-patient relationship should not be the only basis for finding that a physician owes a duty of care to a particular person. We will address that issue later in this opinion."

  Id. at 593.
• "In most jurisdictions in which the issue has been addressed, courts continue to require the plaintiff in a medical malpractice case to prove the existence of a physician-patient relationship, but most courts also state that such a relationship is implied if the physician affirmatively undertakes to diagnose and/or to treat the plaintiff." Id.
• "In light of the increasing complexity of the health care system, in which patients routinely are diagnosed by pathologists or radiologists or other consulting physicians who might not ever see the patient face-to-face, it is simply unrealistic to apply a narrow definition of the physician-patient relationship in determining whether such a relationship exists for purposes of a medical malpractice case.^FN15 Based upon the foregoing authorities, we hold that a physician-patient relationship may be implied when a physician affirmatively undertakes to diagnose and/or treat a person, or affirmatively participates in such diagnosis and/or treatment.

  FN15 See e.g. Raptis‑Smith v. St. Joseph's Med. Ctr., 755 N.Y.S.2d 384, 386 (N.Y. App. Div. 2003) (discussing physician-patient relationship between plaintiff and radiologist); Peterson v. St. Cloud Hosp., 460 N.W.2d 635, 638 (Minn. Ct. App. 1990) (discussing physician-patient relationship between plaintiff and pathologist)."

  Id. at 596.