1 No. 20
Sheila E. Horn,
Respondent, v. The New York Times,
Appellant.
2003 NY Int. 25
February 25, 2003
This opinion is uncorrected and subject to revision before
publication in the New York Reports.
Bernard M. Plum, for appellant. Pearl Zuchlewski, for respondent. New York City Partnership; New York State Psychiatric
Association, Inc. et al.; National Employment Lawyers
Association/New York; Medical Society of the State of New York,
et al.; The Business Council of New York State, Inc., amici curiæ.
READ, J.:
At issue in this appeal is whether the narrow exception
to the at-will employment doctrine adopted in Wieder v Skala (, 80 NY2d 628 [1992]) encompasses a physician employed by a non-
medical employer. For the reasons that follow, we conclude that
it does not and decline to expand the Wieder exception to do so.
Accordingly, we reverse. I. In her complaint, Sheila E. Horn, D.O., formerly the
Associate Medical Director of the Medical Department of the New
York Times, alleges that her primary responsibilities in this
position were to provide medical care, treatment and advice to
employees of the Times. Among other things, * * * determining if
injuries suffered by Times employees were work-related, thus
making the employees eligible for Worker's Compensation
payments. She worked at the Times' main building in mid-town
Manhattan, along with the Medical Director, a physician's
assistant, two nurses and three professional social workers. According to Horn, on frequent occasions personnel in
the Times' Labor Relations, Legal and Human Resources Departments
directed her to provide them with confidential medical records of
employees without the employees' consent or knowledge. She also
claims that personnel in the Times' Human Resources Department
instructed her to misinform employees whether their injuries and
illnesses were work-related so as to curtail the number of
workers' compensation claims filed against the newspaper. Horn consulted with the New York State Department of
Health and other authorities about the propriety and legality
of these directives. The Department of Health supposedly advised
her that if a physician releases patient information and/or
medical records without the consent of the patient, except under
certain narrowly-defined circumstances, the physician is
violating several provisions of state law, the Code of Ethical
Conduct of the American College of Occupational and Environmental
Medicine, the Americans With Disabilities Act, and various
federal regulations. Accordingly, Horn disregarded her
employer's orders and refused to share patient information or
records with non-medical Times personnel without patient consent
or knowledge. In April 1999, the Times decided to restructure its
Medical Department, resulting in the phas[ing] out of the
positions occupied by Horn and the Medical Director and
physician's assistant with whom she had worked, but not those of
other professional personnel in the Medical Department. Horn
contends that this restructuring and the Times' outsourcing of
certain medical services were mere pretexts; that the Times, in
fact, undertook these actions in order to get rid of her because
she was viewed as a troublemaker. Horn contends that her contract of employment with the
Times implied the fundamental understanding, which requires no
written expression, that the physician will conduct her practice
on the employer's behalf in accordance with the ethical standards
of the medical profession (emphasis added). She alleges that
the Times terminated her employment because she resisted
management's entreaties to trench upon patient confidentiality in
violation of unexpressed but commonly understood ethical
standards, and seeks compensatory and punitive damages for breach
of contract.
The Times made a pre-answer motion to dismiss Horn's
complaint for failure to state a cause of action. Supreme Court
denied the motion as to the first cause of action for breach of
contract. Characterizing the issue presented as whether the
exception enunciated in Wieder v Skala (, 80 NY2d 628 [1992]) to
New York's rule relating to employment at-will should be extended
to a physician employed by a non medical entity, Supreme Court
concluded that it should (186 Misc 2d 469, 470 [2000]).[1]
The
Appellate Division affirmed, with two Justices dissenting (293
2 1 [2002]), and subsequently certified the following question
to this Court: Was the order of [the Appellate Division], which
affirmed the order of the Supreme Court, properly made?
II. The traditional American common law rule undergirding
employment relationships, which we adopted in Martin v New York
Life Ins. Co. (148 NY 117 [1895]), is the presumption that
employment for an indefinite or unspecified term is at will and
may be freely terminated by either party at any time without
cause or notice. While the twentieth century featured
significant statutory inroads into the presumption of at-will
employment, most notably with passage of the National Labor
Relations Act in 1935 and Title VII of the Civil Rights Act of
1964, American courts have proved chary of creating common law
exceptions to the rule and reluctant to expand any exceptions
once fashioned ( see Summers, Employment at Will in the United
States: The Divine Right of Employers, 3 U Pa J Lab & Emp L 65
[2000]). Our own jurisprudence reflects this pattern, as a brief
examination of our major cases over the last twenty years
illustrates. In Weiner v McGraw-Hill, Inc. (57 2 458 1982]),
plaintiff Weiner alleged that he was induced to leave his former
employer for McGraw-Hill by assurances of job security. He
claimed that he signed and submitted a McGraw form job
application specifying that his employment was subject to
McGraw's handbook on personnel policies and procedures, which
represented that McGraw would resort to dismissal for just and
sufficient cause only, and only after all practical steps toward
rehabilitation or salvage of the employee have been taken and
failed ( id. at 460); that he relied on these undertakings in
good faith when he left his former employer to work for McGraw,
thereby forfeiting accrued fringe benefits and foregoing a
promised salary increase; that he routinely rejected other offers
of employment to remain at McGraw because of these assurances;
and that he was instructed by his supervisors to adhere strictly
to the handbook's procedures when considering the dismissal of
subordinates. When Weiner was subsequently dismissed without
just cause or an opportunity for rehabilitation, we found these
cumulative factors sufficient to state a cause of action for
breach of contract. A scant four months later in Murphy v American Home
Prods. Corp. (58 2 293 [1983]), we considered whether a long-
tenured corporate employee allegedly discharged in part[2]
for
reporting accounting improprieties to top management had stated a
cause of action in tort for abusive discharge, or in contract for
breach of an implied covenant of good faith and fair dealing.
Plaintiff Murphy, an assistant treasurer in a corporation, urged
us to recognize the tort of abusive or wrongful discharge of an
at-will employee, pointing out that other jurisdictions had done
so where employees were dismissed in retaliation for employee
conduct protected by public policy. Judge Jones, writing for the majority, emphatically
turned down Murphy's invitation, being of the opinion that such
a significant change in our law is best left to the Legislature,
which is well-situated to discern the public will, to examine
the variety of pertinent considerations, to elicit the views of
the various segments of the community that would be directly
affected and in any event critically interested, and to
investigate and anticipate the impact of any major change in the
at-will employment rule ( id. at 302). In short, if this rule
were to be tempered, it should be accomplished through a
principled statutory scheme, adopted after opportunity for public
ventilation, rather than in consequence of judicial resolution of
the partisan arguments of individual adversarial litigants
( id.).
Murphy further argued that the law implies a covenant
of good faith and fair dealing in all contracts, including
employment contracts of indefinite duration; that he was required
to disclose accounting improprieties by virtue of his terms of
employment; and therefore that his employer's discharge of him
for having done so constituted a breach of contract. Citing the
venerable case of Wood v Duff-Gordon (222 NY 88 [1917]), Judge
Jones acknowledged that New York recognizes an implied and
enforceable obligation of good faith and fair dealing on the part
of a party to a contract in appropriate circumstances; however,
[i]n such instances the implied obligation is in aid
and furtherance of other terms of the agreement of the
parties. No obligation can be implied, however, which
would be inconsistent with other terms of the
contractual relationship. * * * [U]nder New York law
as it now stands, absent a constitutionally
impermissible purpose, a statutory proscription, or an
express limitation in the individual contract of
employment, an employer's right at any time to
terminate an employment at will remains unimpaired (58
2 at 304-305 [emphasis added]). We next visited at-will employment in Sabetay v
Sterling Drug (69 2 329 [1987]). Plaintiff Sabetay asserted
that he was discharged on account of his refusal to participate
in certain improper, unethical and illegal financial activities
in violation of contractual obligations derived from the
corporate personnel policy manual and the corporation's
accounting codes. We reiterated that a covenant of good faith
and fair dealing can be implied only where the implied term is
consistent with other mutually agreed upon terms in the contract
( id. at 335); and again observed that significant alteration of
employment relationships *** is best left to the Legislature
[citations omitted], because stability and predictability in
contractual affairs is a highly desirable jurisprudential value
( id. at 336). In Weiner, Murphy and Sabetay, we thus exhibited a
strong disinclination to alter the traditional rule of at-will
employment. It was in this context that we decided Wieder v Skala
(80 2 628 [1992]), the case upon which Horn pins her faith. Plaintiff Wieder, an associate in a law firm, asked the
firm to assign another associate to represent him in a real
estate transaction. This associate neglected the project and
then lied to Wieder in order to cover up his inattention. When
Wieder asked the firm's partners to report the associate's
misconduct to the Appellate Division's Disciplinary Committee, as
required by DR 1-103 (A) of New York's Code of Professional
Responsibility (22 NYCRR 1200.4), they balked. When the firm
subsequently dismissed Wieder, he sued, claiming retaliatory
discharge and breach of implied contract. Supreme Court
dismissed his complaint on account of the employment-at-will
doctrine and the Appellate Division affirmed. We rejected Wieder's argument that the dictates of
public policy in DR 1-103 (A) have such force as to warrant * * *
recognition of the tort of abusive discharge (80 2 at 638-
639). Moreover, we relied upon Murphy and Sabetay for the
proposition that major alterations in employment relationships
are best left to the Legislature, pointing out the Legislature's
enactment of the Whistleblower's Law (Labor Law § 740; Civil Service Law § 75-b). Although we reinstated the cause of action
for breach of contract, we were careful to limit the reach of the
exception to the at-will employment doctrine thus created and to
preserve Murphy and Sabetay. Critically, we observed that the plaintiffs in Murphy
and Sabetay, employees working in the financial departments of
large companies, provided professional accounting services in
furtherance of their corporate responsibilities. By contrast,
Wieder's provision of professional services to the firm's clients
as a member of the Bar was at the very core and, indeed, the
only purpose of his association with [the law firm] * * * [his]
duties and responsibilities as a lawyer and as an associate of
the firm [are] so closely linked as to be incapable of
separation ( id. at 635 [emphasis added]). We also considered the particular ethical rule at issue
in Wieder to be indispensable to the unique function of attorney
self-regulation, a judgment that we are best-situated to make
since the regulation of lawyers in New York has been delegated by
the Legislature to the Judiciary ( seeJudiciary Law § 90 [2]; see
also People v ex rel. Karlin v Culkin, 248 NY 465, 480 [1928]
[If the house is to be cleaned, it is for those who occupy and
govern it, rather than for strangers, to do the noisome work]).
Further, Wieder's failure to comply with DR 1-103 (A) put him at
risk of suspension or disbarment. We accordingly concluded that these unique
characteristics of the legal profession in respect to [DR 1-103
(A)] make the relationship of an associate to a law firm employer
intrinsically different from that of the financial managers to
the corporate employers in Murphy and Sabetay, which call[ed]
for a different rule regarding the implied obligation of good
faith and fair dealing ( Wieder, 80 NY2d at 637). We were
careful to point out, however, that we did not mean to suggest
that each provision of the Code of Professional Responsibility
should be deemed incorporated as an implied-in-law term in every
contractual relationship between or among lawyers ( id.). Finally, and at the heart of our holding, we observed
that Wieder and the law firm were engaged in a common
professional enterprise, the practice of law. Because of their
common endeavor, Wieder and his firm were mutually bound to
follow DR 1-103 (A). We specifically quoted the passage in
Murphy (reprised in Sabetay) warning that in order for any
condition to be implied in a contract, that condition must aid
and further the agreement's underlying terms, and held that DR 1-
103 (A) did so because [u]nlike Murphy and Sabetay, giving
effect to an implied understanding _- that in their common
endeavor of providing legal services [Wieder] and the firm would
comply with the governing rules and standards and that the firm
would not act in any way to impede or discourage [Wieder's]
compliance _- would be 'in aid and furtherance of [the central
purpose] of the agreement of the parties' ( id. at 638 [quoting
Murphy, 58 NY2d at 304][fourth alteration in original]). III. We determined that the plaintiff in Wieder stated a
cause of action for breach of an implied-in-law obligation in an
at-will employment relationship because of the unique confluence
of specific, related factors. Although Horn strikes a
sympathetic, and even a seductive, chord ( Horn v New York Times,
293 AD2d at 12), she has failed to plead facts that place her
claim for breach of contract within the Wieder exception to the
at-will employment rule. First, Horn was employed as the Associate Medical
Director of the Times' in-house Medical Department, where
whatever medical care and treatment she rendered was provided
only to fellow employees and only as directed by her employer.
Moreover, while Horn alleges that, in fact, her primary
responsibilities were to provide medical care, treatment and
advice to employees of the Times, the sole concrete example of
these primary responsibilities offered in her complaint is the
determin[ation] if injuries suffered by Times employees were
work-related, thus making the employees eligible for Worker's
Compensation payments.
When Horn made assessments as to whether a Times
employee had suffered a work-related illness or injury, she was
surely calling upon her knowledge as a physician, but not just
for the benefit of the employee. Rather, she was applying her
professional expertise in furtherance of her responsibilities as
a part of corporate management, much like Murphy and Sabetay and
unlike Wieder. Concomitantly, to the extent that Horn, in fact,
treated Times employees as part of her job responsibilities, her
provision of these professional services did not occupy the very
core or the only purpose of her employment with the Times,
unlike Wieder's provision of legal services for his firm's
clients. Next, the commonly understood ethical standards that
the Times allegedly directed Horn to violate at the risk of
losing her professional license include CPLR 4505 (the physician-
patient privilege, an evidentiary rule) and provisions in the
Education Law and the Rules of the Board of Regents.[3]
These
provisions were not central to Horn's conduct [of] her practice
on her employer's behalf.
We by no means intend to deny or belittle the
importance of physician-patient confidentiality, which we just
recently affirmed in Matter of Grand Jury Investigation in New
York County v Morgenthau (, 98 NY2d 525 [2002]). Nonetheless, the
principle of physician-patient confidentiality -- unlike DR 1-103
(A) -- is not a self-policing rule critical to professional self-
regulation. More importantly, because of the absence of a common
professional enterprise between Horn and the Times, the Education
Law provisions cited by Horn do not impose a mutual obligation on
the employer and the employee in this case. Our dissenting colleague would compensate for the
absence of a mutual obligation flowing from a common professional
enterprise by substituting the notion that the Times knew or
should have known about Horn's professional responsibility to
protect patient confidentiality. By loosing Wieder from its
analytical moorings, however, the dissent would create a broad
new exception to the presumption of at-will employment,
applicable to hosts of professional employees. The only exceptions to the employment-at-will rule ever
adopted by this Court have involved very specific substitutes for
a written employment contract: in Weiner, the employer's express,
unilateral promise on which the employee relied; in Wieder, the
parties' mutual undertaking to practice law in compliance with DR
1-103 (A), a rule so fundamental and essential to the parties'
shared professional enterprise that its implication as a term in
their employment agreement aided and furthered the agreement's
central purpose. We have consistently declined to create a
common law tort of wrongful or abusive discharge, or to recognize
a covenant of good faith and fair dealing to imply terms grounded
in a conception of public policy into employment contracts, as
the dissent would have us do, and we again decline to do so. The
good and sufficient reasons underlying this forbearance, so
eloquently expressed by Judge Jones in Murphy, have not changed,[4]
and Horn has presented us with no compelling reason in the facts
of this case to expand the Wieder exception to the at-will
employment rule. Accordingly, the order of the Appellate Division should
be reversed, with costs; defendant's motion to dismiss the first
cause of action granted; and the certified question answered in
the negative.
Horn v The New York Times
No. 20
Smith, J. (dissenting):
Because I believe that plaintiff Sheila Horn has stated
a claim for breach of an implied contract between herself and
defendant The New York Times, I dissent. I would affirm the
order of the Appellate Division. Plaintiff began her employment as a physician with The
Times in 1995. In 1996, she became the full-time Associate
Medical Director of The Times' Medical Department. Sometime in
April 1999, however, Dr. Horn was terminated. In April 2000, she
commenced an action, alleging breach of contract (first cause)
and an entitlement to punitive damages (second cause). In May
2000, The Times filed a pre-answer motion to dismiss the
complaint for failure to state a cause of action. Supreme Court
denied the motion as to the first cause, finding that Dr. Horn
had stated a claim for breach of an implied contract of
employment. Supreme Court reasoned that the strictures imposed
upon those in the medical profession, and the resulting
responsibility to the public, warranted extension of the
principles set forth in Wieder v Skala (, 80 NY2d 628 [1992]).
Supreme Court granted the motion as to the second cause which
asserted only a claim for punitive damages. The Appellate
Division affirmed, with two justices dissenting (293 2 1
[2000]). The Appellate Division certified to this Court the
question of whether it had correctly affirmed Supreme Court. "On a motion to dismiss pursuant to CPLR 3211 , we must
accept as true the facts as alleged in the complaint and
submissions in opposition to the motion, accord plaintiffs the
benefit of every possible favorable inference and determine only
whether the facts as alleged fit within any cognizable legal
theory" ( Sokoloff v Harriman Estates Dev. Corp., , 96 NY2d 409, 414
[2001][citations omitted]). If the motion is denied, defendant
has the right to submit an answer and address the merits.
Dr. Horn's complaint alleged that her primary
responsibilities were to provide "medical care, treatment and
advice" to the company's employees and to examine employees
seeking Workers' Compensation benefits to verify that their
claims were work related. She further alleged that on "frequent
occasions" various named departments of the company directed her
to provide them with confidential medical records of employees
"without those employees' consent or knowledge," and that the
vice president for human resources instructed her to "misinform
employees regarding whether injuries or illnesses they were
suffering were work-related so as to curtail the number of
Workers' Compensation claims filed against The Times." After
seeking advice from the New York State Department of Health, she
was told "if a physician releases patient information and/or
medical records without the consent of the patient, except under
certain, narrowly-defined circumstances, that physician is
violating several provisions of state law, The Code of Ethical
Conduct of the American College of Occupational and Environmental
Medicine, the Americans With Disabilities Act, and various
federal regulations." Thereafter, she refused to comply with
requests to turn over patients' medical records to other
department heads without the patients' consent. In April 1999, the human resources vice president
announced that The Times was restructuring the medical department
and as a result, the positions of Dr. Horn and Dr. DiPietro were
eliminated. DiPietro had also failed to comply with requests
from Labor Relations and other Times' departments for patient
medical records without those patients' consent. Dr. Horn
asserted that The Times thereafter contracted with Meridian
Corporate Healthcare to provide a physician to work three days
per week at the Times' main office, the place where she had
worked. Dr. Horn asserted that she applied for the position but
was not granted an interview. Human resources asserted economic
reasons for the restructuring of the medical department. Dr.
Horn alleged that she was terminated because she refused to
comply with requests for confidential patient records and that
her termination constituted a breach of the implied terms and
conditions of the agreement between herself and The Times. In hiring Dr. Horn, The Times impliedly committed to
permitting her to perform her professional responsibilities in a
manner not inconsistent with the ethical practice of medicine,
and because Dr. Horn alleged in her complaint that The Times
breached that agreement, she has stated a cognizable cause of
action. In its decision, the Supreme Court stated:
The conduct that plaintiff herein
asserts resulted in her discharge
is not merely 'whistle blowing'
type activity *** but rather is
affirmative conduct which defendant
allegedly requested plaintiff to
perform which could have an adverse
affect on her patients and result
in her losing her license to
practice medicine, as well as the
imposition of civil liability
( Horn v New York Times, 186 Misc 2d
469, 474 [2000]).
The Appellate Division stated:
We cannot accept defendant's
argument that nothing in the law
prevents it from firing the
associate director of its medical
department for refusing to divulge
confidential patient information.
Instead, we hold that a physician
may claim an exception to New
York's employment-at-will doctrine
based on an implied-in-law
obligation of her employer to, at
the very least, do nothing to
prevent her from practicing
medicine in compliance with the
ethical standards of the medical
profession ( Horn v New York Times,
293 AD2d 1, 3 [2002]). Prior to the decision in Wieder v Skala, the long
settled rule in New York was that "where an employment [was] for
an indefinite term it [was] presumed to be a hiring at will which
[might] be freely terminated by either party at any time for any
reason or even for no reason" ( Murphy v American Home Prods.
Corp., , 58 NY2d 293, 300 [1983][cases omitted]). Accordingly, the
Murphy Court declined to "judicially engraft[]" a good faith
limitation on "the unfettered right of termination lying at the
core of an employment at will" ( id. at 305 n 2). Judge Meyer, on
the other hand, noted in dissent that "[t]he at-will rule was
created by the courts and can properly be changed by the courts
but, more importantly, * * * , the rule ha[d] for at least a
century been subject to the 'universal force' of the good faith
rule. The Legislature, therefore, had no reason before the
[ Murphy] decision to believe that action on its part was
required" ( id. at 314).
In Wieder, however, this Court recognized that in
certain contractual situations, an obligation of good faith and
fair dealing arises which limits an employer's unfettered right
to terminate at will. In Wieder, an associate who had been
working for a law firm, brought a claim alleging that the firm in
terminating him, breached an implied term of his contract - -
that the firm would do nothing to subvert the associate's ethical
and lawful practice of law. The associate alleged that he had
been wrongfully terminated because he insisted that the firm
comply with Disciplinary Rule 1-103 (A) of the Code of
Professional Responsibility, which requires an attorney to report
the professional misconduct of another attorney.[5]
In his
complaint, the associate alleged that the firm had agreed to
represent him in the purchase of a condominium apartment and had
assigned a fellow associate to do everything that needed to be
done. The fellow associate neglected the transaction for several
months and made "false and fraudulent material
misrepresentations" to conceal his neglect. When the associate
learned of his fellow associate's neglect and false statements,
he advised two senior partners. They conceded that they were
aware of the fellow associate's having lied about pending legal
matters on other occasions. The fellow associate admitted in
writing that he had committed several acts of legal malpractice,
fraud and deceit upon the associate and other clients. The
associate alleged that the firm's partners refused to report the
misconduct to the Appellate Division Disciplinary Committee as
required under DR 1-103 (A). The associate met with the
Committee, but later withdrew his complaint, he alleged, because
the firm had indicated that he would be terminated if he reported
the misconduct of his fellow associate. Plaintiff alleged he was
berated, and, after completing important litigation, was
terminated. This Court, in seeking to determine if an obligation of
good faith and fair dealing could be implied in the contract,
observed:
"It is the law that in `every
contract there is an implied
undertaking on the part of each
party that he will not
intentionally and purposely do
anything to prevent the other party
from carrying out the agreement on
his part.' The idea is simply that
when A and B agree that B will do
something it is understood that A
will not prevent B from doing it.
The concept is rooted in notions of
common sense and fairness * * *.
[It is] a recognition that the
parties occasionally have
understandings or expectations that
[are] so fundamental that they [do]
not need to negotiate about those
expectations" ( id. at 637
[citations and quotations
omitted]).
The Court also examined the nature of the relationship between
the associate and the firm to see what could be implied in the
contract. The Court observed that the relationship between the
law firm and the lawyer hired as an associate was unique because
(1) the associate was specifically hired to perform services for
clients as a duly admitted member of the bar, but at the same
time, the associate remained an independent officer of the court
responsible to a broader public sense of professional
obligations; (2) particularly critical to "survival of the
[legal] profession" was the obligation of self regulation imposed
by DR 1-103 (A); and finally (3) because the associate and the
firm were engaged in a common professional enterprise each was
governed by the same general "rules of conduct and ethical
standards * * * in carrying out the sole aim of their joint
enterprise, the practice of their profession." The Court
recognized that "[i]ntrinsic to this relationship, of course, was
the unstated but essential compact that in conducting the firm's
legal practice both plaintiff and the firm would do so in
compliance with the prevailing rules of conduct and ethical
standards of the profession. Insisting that as an associate in
their employ plaintiff must act unethically and in violation of
one of the primary professional rules amounted to nothing less
than a frustration of the only legitimate purpose of the
employment relationship" ( id. at 637-638). As in Wieder, a similar promise by The Times, to permit
Dr. Horn to perform her professional responsibilities in a manner
not inconsistent with the ethical practice of medicine, should be
implied in its relationship with plaintiff. Dr. Horn alleges
that The Times hired her to perform core medical duties for
clients. Specifically, she alleges that she was hired to provide
"medical care, treatment and advice" to the company's employees
and to examine employees seeking Workers' Compensation benefits
to verify that their claims were work related. Such duties
required her to use the medical skills she had acquired through
training and practice as a physician. Dr. Horn makes no
allegation that can reasonably be read to assert that she was
hired to do anything but perform as a physician. The Majority
would distinguish Dr. Horn's duties at The Times as incorporating
"corporate management" duties to be distinguished from "the very
core" or "only purpose" attorney duties of the associate in
Wieder. The associate in Wieder did not plead in his amended
complaint that his attorney functions were his "sole functions;"
rather, he pleaded that he "was associated with the law firm
* * * and practiced solely in the area of commercial litigation."
As stated by the Majority at the Appellate Division,
Any employer who hires a physician to provide medical care
knows, or should know as a matter of common knowledge, that the
physician is bound by the patient confidentiality provision of
the ethical code of the medical profession (293 2 at 8).
Like the associate in Wieder, Dr. Horn remained a duly admitted
member of a professional body and was bound by its rules. The
Code of Medical Ethics both requires the confidentiality of
information obtained by a physician in plaintiff's position and
the reporting of physicians who violate that confidentiality.[6]
In addition, section 6530 (23) of the Education Law defines as
professional misconduct, the "[r]evealing of personally
identifiable facts, data or information obtained in a
professional capacity without the consent of the patient * * *."
Section 6509 (9) of the Education Law defines professional
misconduct to include "[c]ommitting unprofessional conduct as
defined by the board of regents." Section 29.1(b)(8) of the
Rules of the Board of Regents defines professional misconduct to
include the "revealing of personally identifiable data or
information obtained in a professional capacity * * *." The
State of New York Department of Health has set forth a penalty of
censure, reprimand, suspension of license, revocation of license,
annulment of license, limitation on further license or fine for a
person found guilty of professional misconduct ( seePublic Health Law § 230-a). The Department has suspended the license of a
physician who evidenced moral unfitness by engaging in sexual
relations with his patients, who revealed patient information
without consent, who harassed and/or intimidated a patient and
who failed to maintain accurate information ( see Matter of Dieter
H. Eppel, M.D., Determination and Order No. 02-82 of the
Professional Medical Conduct Administrative Review Board; see also Matter of James Y. Severinsky, M.D., Determination and Order
No. BPMC 00-226 of the New York State Board of Professional
Medical Conduct [suspending the licence of a physician who
revealed patient's personally identifiable information obtained
in a professional capacity without patient's consent and
committed professional misconduct by practicing fraudulently and
advertising falsely]; Matter of James L. Duffy, M.D.,
Determination and Order No. BPMC 00-129 of the New York State
Board of Professional Medical Conduct [suspending the license of
physician who engaged in sexual relations with a patient,
revealed personally identifiable facts, data, or information
about patient without consent, was grossly negligent, negligent
and failed to maintain accurate records]). The Department of Health, like the Departments of the
Appellate Division, is responsible for maintaining standards and
ethics of the profession and for enforcing those standards. In
addition, the Principles of Medical Ethics of the American
Medical Association states that physicians, including physicians
employed by industry, have an ethical and legal duty to protect
patient confidentiality and thus not to reveal confidential
communications without the consent of the patient. The critical
similarity between the rule governing Dr. Horn and the rule
governing the associate in Wieder is not that the rule needs to
reflect the profession's self-governing function - - this is just
a particular function of the legal profession. What is critical
is that the profession regards the rule as intrinsic to its
survival as a profession. As to the third factor, the so called common enterprise
factor, I agree with the Appellate Division that although Dr.
Horn and The Times were not engaged in the same work, it is
beyond cavil and universally known that a physician owes her
patients a duty of confidentiality. Indeed, this Court observed
in Matter of Grand Jury Investigation in New York County v
Morgenthau (98 2 525 [2002]) that the physician-patient
privilege served three functions: (1) it "seeks to maximize
unfettered patient communication with medical professionals, so
that any potential embarrassment arising from public disclosure
will not deter people from seeking medical help and securing
adequate diagnosis and treatment;" (2) it "encourages medical
professionals to be candid in recording confidential information
in patient medical records, * * *;" and (3) it "protects
patients' reasonable privacy expectations against disclosure of
sensitive personal information ( id. at 529 [citations and
quotations omitted]). Just because The Times was "not a medical
entity and therefore [was] not bound itself by the governing
rules and standards of the medical profession [did] not negate
the implied understanding in their relationship that the employer
will not impede or discourage the physician's compliance with
those particular rules and standards" ( Horn v The New York Times,
293 AD2d at 8, citing Wieder at 638). This State's interest in protecting both the employer's
and the employee's freedom of contract undergirds the employment-
at-will doctrine. Nevertheless, even if the facts alleged in the
complaint did not come within the Wieder rule, the strictures of
the at-will doctrine itself, a judge-made doctrine, have been
subject to a limited number of statutory exceptions ( seeLabor Law § 741[2][a] [preventing retaliatory discharge of healthcare
employee making report of improper quality of patient care];
Labor Law § 740 [preventing retaliatory discharge against an
employee who reports an employer's illegal activity creating a
substantial and specific danger to public health and safety];
Civil Service Law § 75-b [preventing retaliatory discharge of
public employee who reports violation of federal, state or local
law]; see also National Labor Relations Act of 1935, 29 USC 158,
et seq [defining unfair labor practices]; Title VII of the Civil
Rights Act of 1964, 42 USC § 2000e et seq [stating that it shall
be an unlawful employment practice to discriminate against
members of named suspect categories]). It should be emphasized, however, that Dr. Horn's claim
comes within the limited exception to the at-will doctrine carved
out in Wieder, legal professionals (here medical professionals)
performing public duties, not corporate duties, whose employers
take adverse action against them because they insist upon
complying with an identifiable statutory duty or ethical
principle which is at the core of their profession. The
contention of the Majority that the dissent advocates a broad
application of Wieder to all professionals is a misreading.
Rather the dissent contends only that the rules and obligations
which govern the conduct of doctors are similar to the rules
applicable to lawyers. The most obvious of these rules is
confidentiality. No sound reason exists to preclude termination of a
lawyer in Wieder while leaving without a remedy a doctor whose
job it is to protect the physical and mental well-being of
individuals. Even though The Times is not in the business of
practicing medicine, [i]t is significant * * * that The Times, a
universally respected news organization, itself provides an
essential service to the public that entails conforming to
certain standards of truth, integrity and confidentiality of its
news sources ( see e.g. the Shield Law [Civil Rights Laws 79-h])
( Horn v The New York Times, 293 AD2d at 11).
Accordingly, I would affirm.
Footnotes
1 Supreme Court dismissed the second cause of action on the
ground that there is no separate cause of action for punitive
damages. Horn did not appeal this aspect of the order.
2 Murphy also alleged that he had been fired because he was
over 50 years old.
3 These provisions include Education Law § 6509 (9) (defining
professional misconduct for those admitted to each of the 27
professions subject to licensure by the Department of Education
to include [c]ommitting unprofessional conduct, as defined by
the board of regents, coupled with section 29.1 (b) (8) of the
Rules of the Board of Regents, defining professional misconduct
for those admitted to each of the 27 professions subject to
licensure by the Department of Education to include revealing of
personally identifiable facts, data or information obtained in a
professional capacity without the prior consent of the patient or
client, except as authorized or required by law (8 NYCRR 29.1
[b] [8]; see also 8 NYCRR 29.4 [a]); and Education Law § 6530
(23) (specifying professional misconduct for the commission of
which a physician licensee is subject to those penalties
prescribed in section 230-a of the Public Health Law [e.g.,
censure and reprimand, suspension, limitation or revocation of
license] to include the [r]evealing of personally identifiable
facts, data, or information obtained in a professional capacity
without the prior consent of the patient, except as authorized or
required by law; cf. 8 NYCRR 29.1 [b] [8]).
4 We note that the Legislature remains active in this area,
just last year having enacted a new Whistleblower Law to protect
certain health care workers ( see Labor Law § 741).
5 DR 1-103 (A) provides: A lawyer possessing knowledge, not
protected as a confidence or secret, of a violation of DR 1-103
that raises a substantial question as to another lawyer's
honesty, trustworthiness or fitness in other respects as a lawyer
shall report such knowledge to a tribunal or other authority
empowered to investigate or act upon such violation.
6 Rule E-5.09 of the Code of Medical Ethics states in part:
Where a physician's services are limited to performing an
isolated assessment of an individual's health or disability for
an employer, business or insurer, the information obtained by the
physician as a result of such examinations is confidential and
should not be communicated to a third party without the
individual's prior written consent, unless required by law. If
the individual authorized the release of medical information to
an employer or a potential employer, the physician should release
only that information which is reasonably relevant to the
employer's decision regarding that individual's ability to
perform the work required by the job.
When a physician renders treatment to an employee with a work-
related illness or injury, the release of medical information to
the employer as to the treatment provided may be subject to the
provisions of worker's compensation laws. The physician must
comply with the requirements of such laws, if applicable.
However, the physician may not otherwise discuss the employee's
health condition with the employer without the employee's consent
or, in the event of the employee's incapacity, the appropriate
proxy's consent.
Rule E-9.031 of the Code of Medical Ethics states in part:
Physicians have an ethical obligation to report impaired,
incompetent, and unethical colleagues in accordance with the
legal requirements in each state and assisted by the following
guidelines:
Unethical conduct. With the exception of incompetence or
impairment, unethical behavior should be reported in accordance
with the following guidelines:
Unethical conduct that threatens patient care or welfare should
be reported to the appropriate authority for a particular
clinical service. Unethical behavior which violates state
licensing provisions should be reported to the state licensing
board or impaired physician programs, when appropriate.
Unethical conduct which violates criminal statutes must be
reported to the appropriate law enforcement authorities. All
other unethical conduct should be reported to the local or state
medical society.