THOMPSON, Judge.
¶ 1 This special action arises from a personal injury lawsuit in which a treating physician refused to testify unless he was compensated as an expert witness. The superior court ordered Santiago Sanchez (Sanchez), the defendant below, to compensate the treating physician as an expert witness. The narrow issue we address is whether a treating physician's testimony concerning diagnosis, treatment, and prognosis is expert testimony because it draws upon his or her skill, training, and experience as a doctor. For the following reasons, we accept jurisdiction of the special action petition and grant relief.
¶ 2 Heydy Santizo Hernandez (Hernandez) was involved in a motor vehicle accident with Sanchez in Scottsdale, Arizona. Hernandez sued Sanchez for personal injury damages resulting from the accident, and alleged that she required chiropractic treatment from Injury Chiropractic. As part of her prima facie case, Hernandez would have to prove that she was injured, and that her treatment and
¶ 3 During discovery, Sanchez subpoenaed Dr. Hobbs to take his deposition. Dr. Hobbs filed a motion to quash the subpoena, or in the alternative, sought entry of a protective order limiting the scope of inquiry by defense counsel and requiring Sanchez to pay expert witness fees in advance. Dr. Hobbs sought to limit the issues to: (1) the care and treatment of Hernandez; (2) the documentation and record-keeping related to the care provided; (3) the reasonableness of the medical services provided; and (4) the philosophy and modalities of the type of chiropractic medicine engaged in by Dr. Hobbs regarding Hernandez's medical condition. On October 17, 2012, Judge Gama granted the motion and agreed that Dr. Hobbs was an expert for purposes of Arizona Rule of Civil Procedure 26(b)(4)(A) & (C).
¶ 4 Special action jurisdiction is appropriate when a petitioner does not have an "equally plain, speedy, or adequate remedy by appeal." Ariz. R.P. Spec. Act. 1(a); State ex rel. Romley v. Superior Court, 172 Ariz. 109, 111, 834 P.2d 832, 834 (App.1992). Where the issue is a purely legal question of first impression, is of statewide importance, and will arise again, special action jurisdiction may be warranted. Vo v. Superior Court, 172 Ariz. 195, 198, 836 P.2d 408, 411 (App.1992).
¶ 5 The petition presents a purely legal question of statewide importance affecting numerous cases. The lack of guidance in this area has resulted in conflicting superior court rulings. Consequently, we exercise our discretion and accept special action jurisdiction.
¶ 6 Sanchez asserts that he should not have been required to pay expert witness compensation of Dr. Hobbs because of his specialized chiropractic knowledge, even though he would only be testifying about his examination, treatment, bills, and chiropractic opinions formed during treatment of Hernandez. It is undisputed that Dr. Hobbs was not retained for purposes of this litigation, and that his expected testimony is based on his care and services during the treatment of Hernandez, not opinions formed after Hernandez's discharge from care in anticipation of litigation. Thus, the narrow issue in this special action is whether a treating physician's testimony concerning the patient's diagnosis, treatment, and prognosis is "expert testimony" within the meaning of our rules simply because it necessarily draws upon his or her skill, training, and experience as a doctor.
¶ 7 Sanchez argues this case is governed by State ex rel. Montgomery v. Whitten, 228 Ariz. 17, 262 P.3d 238 (App.2011), which addressed whether a treating physician is entitled to an expert witness fee in criminal cases. Whitten was a first degree murder and child abuse case in which the trial court ordered that six of the treating physicians be compensated as expert witnesses if called at trial despite the state's avowal that it would only question the doctors regarding their medical treatment of the child. Id. at 19-20,
¶ 8 We held that "[a] fact witness typically testifies about information he or she has acquired independent of the litigation, the parties, or the attorneys." Id. at ¶ 14. Thus, a medical fact witness would not be required to perform additional work in order to answer questions other than reviewing his own records. Id. Fact-based testimony is derived from the five senses, i.e., what the treating doctor saw, heard, or felt, and typically is given in response to the "who, what, when, where, and why" questions. Id. at ¶ 15. Questions about experience, training, and the professional's background and specialization are "relevant to jurors in assessing the credibility of fact witnesses and in determining the weight to give their testimony." Id. at ¶ 13. In addition, having the doctors "educate" the jurors by explaining terms and procedures in a manner more understandable for the trier of fact does not constitute expert testimony. Id. at 22, ¶ 21, 262 P.3d at 243.
¶ 9 In contrast, we concluded testimony would constitute expert testimony requiring appropriate compensation if the questions required "a physician to review records or testimony of another health care provider or to opine regarding the standard of care or treatment given by another provider." Id. at 21, ¶ 16, 262 P.3d at 242. Hypothetical questions or questions regarding causation also may be a signal that the doctor is being asked to give expert testimony. Id. at 21-22, ¶¶ 17, 19-20, 262 P.3d at 242-43. We noted that the "testimony of a treating physician is, by its nature, often more relevant, material, and probative, than that of the retained expert who is not only paid for his testimony but often gleans it from a cold record." Id. at 22, ¶ 21, 262 P.3d at 243 (citation omitted).
¶ 10 Whitten is consistent with Duquette v. Superior Court, 161 Ariz. 269, 270, 778 P.2d 634, 635 (App.1989), a medical malpractice case addressing the issue of attorneys engaging in ex parte communication with a treating physician. Relevant to our discussion here, we stated: "A plaintiff's treating physician is not an `expert witness' within the meaning of Rule 26(b)(4), Arizona Rules of Civil Procedure, because the facts known and opinions held by a treating physician are not `acquired or developed in anticipation of litigation or for trial.'" Id. at 271 n. 2, 778 P.2d at 636 n. 2. Dr. Hobbs asserts that Duquette is "inapt"; if applied here, he argues, Duquette would render Arizona Rule of Civil Procedure 30 meaningless because the Comment to that Rule states that "[t]reating physicians are regarded as disclosed experts for purposes of this rule." Ariz. R. Civ. P. 30, 1991 comm. cmt. (emphasis added). Rule 30 provides that no court order or stipulation is required in order to depose parties or expert witnesses. Ariz. R. Civ. P. 30(a). The phrase "for purposes of this rule" in the Comment refers to Rule 30 and has no impact on Arizona Rule of Civil Procedure 26(b)(4) and whether the treating physician is entitled to be paid as an expert.
¶ 11 Dr. Hobbs argues that Whitten is not persuasive because it involved a criminal matter requiring a civic duty, pointing out our caution that "[n]othing in this opinion, though, should be read as affecting disclosure obligations or witness compensation issues in civil cases." 228 Ariz. at 20 n. 2, ¶ 8, 262 P.3d at 241 n. 2. While a civic duty certainly attends in providing testimony in a criminal matter, civil litigants also have rights to have alleged wrongs addressed and to defend themselves. As with parties in criminal proceedings, civil litigants must have the ability to gather the facts relevant to their cases.
¶ 12 In Whitten, we considered and addressed the issue of treating physician compensation in the criminal context. It is not uncommon for courts to limit the application of their decisions to the issue before them, rather than trying to anticipate the myriad of possible arguments that could be developed or argued in a different application. This
¶ 13 In addition to these cases, many other jurisdictions have reached similar conclusions in civil cases. See, e.g., McDermott v. FedEx Ground Sys., Inc., 247 F.R.D. 58, 60-61 (D.Mass.2007) (holding that the treating physician is entitled to no more than that provided under the statutory witness compensation scheme); Mangla v. Univ. of Rochester, 168 F.R.D. 137, 139 (W.D.N.Y.1996) (deposition questions concerning treating physicians' opinions based on their examination of a patient are a necessary part of the treatment of a patient and "do not make the treating physicians experts"); Baker v. Taco Bell Corp., 163 F.R.D. 348, 349 (D.Colo.1995) (treating physician "testimony is based upon their personal knowledge of the treatment of the patient and not information acquired from outside sources for the purpose of giving an opinion in anticipation of trial"); Clair v. Perry, 66 So.3d 1078, 1079 n. 1 (Fla.Dist. Ct.App.2011) (citing Frantz v. Golebiewski, 407 So.2d 283, 285 (Fla.Dist.Ct.App.1981)) (a treating physician is not generally an expert witness because "a treating doctor ... while unquestionably an expert, does not acquire his expert knowledge for the purpose of litigation but rather simply in the course of attempting to make his patient well"); Brandt v. Med. Def. Assocs., 856 S.W.2d 667, 673 (Mo.1993) ("The treating physician is first and foremost a fact witness, as opposed to an expert witness. In personal injury litigation, the treating physician is likely to be the principal fact witness on the issue of damages; in a medical malpractice case, the treating physician will often also be an important fact witness on liability. Because the treating physician uses medical training and skill both in diagnosing and treating the patient and in describing to the jury the plaintiff's condition and treatment, it is often assumed that the treating physician is automatically an expert witness. Actually, the treating physician only functions as an expert witness to the extent that one or both of the parties ask the witness to use the basic facts to draw conclusions and express opinions on relevant medical issues."); Nesselbush v. Lockport Energy Assocs., L.P., 169 Misc.2d 742, 647 N.Y.S.2d 436, 437 (N.Y.Sup. Ct.1996) (citing Sipes v. United States, 111 F.R.D. 59, 61 (S.D.Cal.1986)) ("[I]t is improper
¶ 14 Not all jurisdictions have agreed with this conclusion, however, citing public policy concerns and a physician's specialized training to support the imposition of a "reasonable fee" requirement for testimony from a treating physician who is not technically an expert witness. See, e.g., Wirtz v. Kan. Farm Bureau Servs., Inc., 355 F.Supp.2d 1190, 1211 (D.Kan.2005) ("[A] treating physician responding to discovery requests and testifying at trial is entitled to his or her `reasonable fee' because such physician's testimony will necessarily involve scientific knowledge and observations that do not inform the testimony of a simple `fact' or `occurrence' witness."); Mock v. Johnson, 218 F.R.D. 680, 683 (D.Haw.2003) ("As opposed to the observations that ordinary fact witnesses provide, the observations and opinions that medical professionals provide derive from their highly specialized training."); Grant v. Otis Elevator Co., 199 F.R.D. 673, 676 (N.D.Okla.2001) ("[T]reating physicians who testify under Fed.R.Evid. 702 as to their diagnoses, treatment and prognoses are experts within the meaning of [Fed.R.Civ.P.] 26(b)(4)(C) and are entitled to a reasonable fee."); Coleman v. Dydula, 190 F.R.D. 320, 323 (W.D.N.Y.1999) ("Physicians provide invaluable services to the public and should be remunerated for their time when they cannot deliver medical care." (citation omitted)). None of these cases, however, provide any logical explanation as to why physicians and no other class of professional or laborer with "specialized knowledge" should be awarded a "reasonable fee."
¶ 15 Dr. Hobbs argues that Arizona Rule of Civil Procedure 26(b)(4)(C), which does not apply to criminal cases, is the true governing law regarding this issue and distinguishes civil cases from Whitten. Rule 26(b)(4) provides in pertinent part:
Dr. Hobbs argues that Rule 26(b)(4) identifies and distinguishes between two types of experts — "one whose opinions may be presented at trial and one who has been retained or specially employed and who is not expected to testify at trial." He goes on to state that Rule 26(b)(4) requires reasonable payment to an expert "who is responding to the discovery request — whether it is a treating physician who is testifying under Rule 702 and Rule 703, Arizona Rules of Evidence, or an accident reconstructionist who is not expected to testify at trial." However, Rules of Evidence 702 and 703, which apply in both civil and criminal cases and which we necessarily considered in Whitten, deal only with witnesses testifying as experts and not as fact witnesses. Therefore, they do not direct that testifying doctors are necessarily experts; rather, they provide rules applicable to doctors who are engaged as experts.
¶ 17 Rule 26(b)(4)(B) does not apply because Dr. Hobbs was not retained or specially employed in anticipation of litigation or preparation for trial. Moreover, most of his testimony was factual in nature. Having found that neither of these usages of "expert" applies here, we similarly conclude that the mandate of Rule 26(b)(4)(C) to pay the "expert" a reasonable fee also does not apply. The Advisory Committee Notes to Federal Rule of Civil Procedure 26(b)(4) recognize as much, stating, "[an] expert whose information was not acquired in preparation for trial but rather because he was an actor or viewer with respect to transactions or occurrences that are part of the subject matter of this lawsuit ... should be treated as an ordinary witness." Our holding is harmonious with the Comment to Arizona Rule of Civil Procedure 26(b)(4), which states that the purpose of the Rule is to avoid unnecessary costs and "to make the judicial system in Arizona more efficient, expeditious, and accessible to the people." Ariz. R. Civ. Proc. 26(b)(4), 1991 comm. & ct. cmts. Requiring parties to pay for the testimony of all treating physicians that are essential to the case but who only testify to the facts would increase the cost of litigation, and in some cases would limit access to the legal system to those most affluent.
¶ 18 Furthermore, we do not think it is appropriate to carve out, for doctors, an exception to the general rule that fact witnesses are not paid for giving testimony. Certainly, treating physicians provide great benefits to society and we do not wish to infringe on their ability to do their important work. However, other professions and trades also provide great benefit to society and have specialized knowledge beyond the lay juror. Courts should not create a special class of fact witnesses who are entitled to expert witness fees while excluding others. We have no basis to weigh the burdens and costs on one profession as opposed to another. We agree with the federal district court of Illinois, which stated:
Demar v. United States, 199 F.R.D. 617, 619-20 (N.D.Ill.2001); see also McDermott, 247 F.R.D. at 61 (there is no "logical explanation as to why [a special] ... rule applies to physicians and no other class of professional or otherwise with `specialized knowledge' about the testimony to be provided"); Mangla, 168 F.R.D. at 140 (physicians will "suffer no more inconvenience than many other citizens called forward to be deposed or testify as a trial witness in a matter in which they have first hand factual knowledge"); cf. Irons v. Karceski, 74 F.3d 1262, 1263-64 (D.C.Cir.1995) (holding that an attorney fact witness was not entitled to be paid his hourly billing rate and not unduly burdened by being compensated the statutory rate for an expected three day deposition); Disability Rights Council of Greater Wash. v. Wash. Metro. Transit Auth., 242 F.R.D. 139, 149-50 (D.D.C.2007) (transportation consultant not compensated as expert because he was not hired in connection with the pending litigation and his information was not acquired in preparation for trial); Leviathan, Inc. v. M/S Alaska Maru, 86 F.R.D. 8, 9 (W.D.Wash. 1979) (holding the captain of a ship involved in a collision was "not an expert retained or specially employed by the party in preparation for trial," and therefore could not refuse to produce his report concerning the incident).
¶ 19 Therefore, we hold that Whitten is applicable to physicians in civil litigation. Whether a treating physician is a fact or expert witness depends on the content of the physician's testimony. When a treating doctor is testifying only to the injury, medical treatment, and other first-hand knowledge not obtained for purposes of litigation, the treating doctor is a fact witness and need not be compensated as an expert. However, where expert testimony is solicited, whether the source of the expert's underlying information is from personal observation or the observations of others, but the testimony is developed for purposes of litigation, the doctors must be compensated accordingly. Often it will depend on the questions being presented to the treating physician. We lean on the discretionary powers of the trial court to determine when expert testimony is being solicited. We acknowledge that it is impossible to anticipate all scenarios and we are not attempting to do so. Our holding in no way entitles parties to abuse physicians by compelling them to give uncompensated expert testimony. The Guidelines for Interprofessional Relationships in Legal Proceedings was an excellent attempt at compromise, and we encourage similar efforts of cooperation and good faith in the future. See Joint Committee on Interprofessional Relationships et al., Guidelines on Interprofessional Relationships in Legal Proceedings 1992/1993 (1993).
¶ 20 Based on the foregoing, we accept special action jurisdiction, grant Sanchez relief and vacate the order compelling expert witness payment to Dr. Hobbs for his testimony relating to the care and treatment of the patient. To the extent Dr. Hobbs's deposition testimony is expert testimony, he must be compensated accordingly.
CONCURRING: JOHN C. GEMMILL, Presiding Judge and DONN KESSLER, Judge.