Worley v. Central Florida Young Men's Christian Ass'n

Citations: 163 So. 3d 1240; 2015 Fla. App. LEXIS 7282; 2015 WL 2259293Docket: No. 5D14-3895

Court: District Court of Appeal of Florida; May 15, 2015; Florida; State Appellate Court

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Heather Worley petitions the court for a writ of certiorari to quash a trial court order mandating her to disclose information about the relationship between her treating physicians and her attorneys at Morgan. Morgan, P.A. The court denies the petition. During discovery in a trip-and-fall case against the Central Florida YMCA, Morgan. Morgan resisted YMCA’s inquiries into how Worley selected her medical providers following her fall in the YMCA's parking lot. Worley sought medical attention at Florida Hospital East and delayed seeing a specialist due to financial constraints. After hiring Morgan. Morgan, she received treatment from various medical facilities. 

During her deposition, when YMCA inquired about referrals from her attorneys, Worley’s counsel claimed attorney-client privilege. Subsequently, YMCA submitted interrogatories and a supplemental request for documents aimed at uncovering the connection between Morgan. Morgan and the medical providers, suggesting a potential "cozy agreement" due to high medical expenses. Worley acknowledged that YMCA could argue the medical bills were excessive. YMCA's requests included information about previous cases involving the treating physicians and their financial arrangements with Morgan. Worley objected, asserting that the discovery demands were overly broad, vague, burdensome, irrelevant, and not permissible under Florida Rule of Civil Procedure 1.280(b)(4).

Worley’s counsel indicated that neither they nor Morgan possess the information related to Worley's treating physicians, suggesting that the YMCA could obtain this information directly from the physicians during depositions. However, Worley filed a motion for a protective order to prevent the YMCA from accessing this information through billing custodians. During depositions, the treating physicians were uncertain about who referred Worley, with some speculating it might have been Florida Hospital East. The trial court upheld Worley’s objection regarding whether her attorneys referred her to the doctors, but overruled other objections. In a subsequent deposition, Worley again objected to questions about her referral due to attorney-client privilege but clarified that she was not referred by any other doctor, Florida Hospital East, or personal contacts. The YMCA then filed a motion to compel better answers, which resulted in the court partially granting their request. Worley was ordered to produce specific documents related to agreements on billing and referrals involving her attorneys and certain medical entities for the period from three years prior to December 4, 2012, to six months thereafter, within 30 days. The court also indicated that if healthcare providers did not have certain documents, the law firm must produce them. The order did not assign costs for compliance, and Worley’s objections to financial discovery concerning medical bills and related documents were upheld without prejudice.

The court indicated it would reconsider a prior ruling if evidence of a billing or referral agreement between attorneys affiliated with Morgan and relevant treating physicians was presented. Worley sought reconsideration, claiming the requested information was protected by attorney-client privilege and that compliance would be excessively burdensome. An affidavit from Morgan's CFO stated there were no documents relevant to the YMCA's request. Worley's attorney identified 238 legal matters requiring significant attorney review time and estimated costs of $94,010 for compliance. The trial court denied Worley’s motion, prompting her to file a petition for writ of certiorari, arguing that the order was improper for six reasons, including the violation of attorney-client privilege and imposing burdens on a nonparty. Certiorari is warranted when a discovery order deviates from legal standards causing irreparable harm, with the reviewing court's first step being the assessment of such harm. The court found that Worley made a prima facie case for irreparable harm regarding attorney-client privilege, establishing grounds for certiorari to review the trial court's order compelling disclosure of privileged information, which could lead to material harm without adequate remedy on appeal.

The order's compliance with legal standards is evaluated, focusing on discovery rules in Florida. Parties can discover relevant, non-privileged information, including the financial relationships between law firms and treating physicians, which may indicate bias (Fla. R. Civ. P. 1.280(b)(1)). Case law supports that such relationships are discoverable and relevant to bias assessment, notably in cases like Brown v. Mittelman and Lytal, Reiter, Smith, Ivey, Fronrath, L.L.P. v. Malay. Discovery into financial bias is particularly pertinent when assessing whether a physician has frequently recommended costly procedures and overcharged in litigation contexts. While a treating physician's financial information is generally discoverable, privacy interests necessitate evidence of a referral relationship before extensive financial details can be sought (Fla. R. Civ. P. 1.280(b)(5)(A)). Courts have recognized the need to protect physicians from invasive discovery, requiring a basis for suspicion of bias before allowing extensive inquiries. In the present case, YMCA has adequately investigated the referral process concerning Worley and confirmed that all treating physicians were uncertain about the referral source.

Worley confirmed in her second deposition that she was not referred to her treating physicians by Florida Hospital East, another doctor, or anyone in her personal network. As a result, YMCA needed to directly inquire with Worley about any referrals. The case of Burt v. Government Employees Insurance Co. established that questions regarding attorney referrals could involve confidential communications. Although the trial court initially prohibited YMCA from asking Worley about referrals from her attorney, subsequent case law has questioned this stance, especially concerning the financial relationships between plaintiffs' attorneys and treating physicians. The Florida Supreme Court emphasized in Boecher the necessity of relevant information for the truth-seeking function of trials.

Consequently, YMCA's inquiry into whether Worley was referred by her counsel or firm was deemed appropriate, contradicting the trial court's earlier ruling. The court's order required Worley to disclose any cases where clients were referred to treating physicians by her attorneys, which was seen as consistent with legal principles. Additionally, the court mandated the production of documents related to any agreements about billing or referrals involving Morgan & Morgan and the treating physicians. This discovery was differentiated from more extensive financial inquiries, as it only sought information on referral relationships, which is relevant and not privileged. Since the information was requested from Worley and her attorneys, rather than the physicians, it did not receive special protection under Florida procedural rules. The trial court's order was upheld as not departing from essential legal requirements.

Worley has not demonstrated a prima facie case of irreparable harm or a deviation from essential legal requirements. The court's order mandates that Worley produce any existing documents related to agreements or referrals between Morgan and the treating physicians, which Worley claims to be nonexistent. However, the court clarifies that Worley must produce any documents that exist, and if none do, she can state that to fulfill her discovery obligations. Worley also argues that the order improperly compels Morgan, a nonparty, to produce information; however, the court supports this based on the doctors' vague testimonies about their interactions with Morgan. Worley is permitted to seek information from Morgan if needed.

Concerns about the burdensomeness and costs of compliance do not exempt Worley from the order, as she can seek compensation for such costs post-trial. The court emphasizes that requiring a party to pay an expert's reasonable fees for responding to discovery facilitates the discovery process and prevents parties from avoiding disclosure due to cost concerns. Furthermore, Worley’s claim that the order extends the scope of permissible bias-related discovery is rejected, as the order pertains to the referral relationships that are relevant to potential physician bias, without necessitating the disclosure of financial records between Morgan and the physicians.

Defense attorneys have the right to seek discovery regarding any referral relationship between opposing counsel and a plaintiff’s treating physician, particularly if there are indications of inflated fees. The petition from Worley is denied, and a conflict is certified with the ruling in Burt v. Government Employees Insurance Co., which held that referrals from attorneys to healthcare providers are always protected by attorney-client privilege. The Florida Supreme Court in Allstate Insurance Co. v. Boecher established that parties can issue discovery requests about their use of and payment to particular experts, a principle extended to treating physicians providing expert testimony at trial. There is no significant difference regarding bias between a treating physician who also acts as an expert and a retained expert, thus allowing inquiry into potential bias both at trial and through pretrial discovery. Florida Rule of Civil Procedure 1.280(b)(5) governs the discovery of expert opinions. The document notes that Worley did not adequately respond to YMCA's discovery requests. Financial estimates for attorney fees were based on an hourly rate multiplied by the estimated hours necessary to review files. The Third District Court of Appeal in Syken v. Elkins established specific criteria for obtaining financial information from medical experts, which was affirmed by the Florida Supreme Court. The trial court must adhere to precedents set by district courts unless interdistrict conflicts arise. It is permissible to conduct discovery to establish a referral relationship between treating physicians and the plaintiff’s law firm, and defense counsel must disclose names of cases where they referred plaintiffs for compulsory medical examinations under Florida Rule of Civil Procedure 1.360. If evidence showed that YMCA or its counsel referred a doctor for examinations in numerous cases, that relationship would also be discoverable.

Requiring defense counsel or insurers to disclose referral information is considered comparable to requiring Morgan and her counsel to reveal the clients referred to healthcare providers. Morgan is entitled to identify any specific materials protected by attorney-client privilege and must object following Florida Rule of Civil Procedure 1.280(b)(6), allowing the trial court to take appropriate measures. When a party claims privilege over discoverable information, they must explicitly state the claim and describe the nature of the withheld documents in a way that allows other parties to evaluate the applicability of the privilege without revealing the privileged information. The trial court previously mandated the production of documents under seal with a privilege log for any privilege claims, including in camera inspection to verify the claims. The court did not address whether the YMCA can discover details about the financial relationships between Morgan and the treating physicians if a referral relationship exists. The court noted that defense counsel and experts are expected to keep financial records of their dealings, suggesting that law firms and physicians involved in referral activities should similarly maintain such records.