Paravecchio v. Memorial Hosp. of Laramie County

• Decision Date: 17 September 1987
• Docket Number: No. 87-22,87-22
• Citation: 742 P.2d 1276
• Parties: Russell F. PARAVECCHIO, D.M.D., Appellant (Plaintiff), v. MEMORIAL HOSPITAL OF LARAMIE COUNTY and DePaul Hospital, Appellees (Defendants).
• Court: Wyoming Supreme Court

Page 1276

742 P.2d 1276

Russell F. PARAVECCHIO, D.M.D., Appellant (Plaintiff), v. MEMORIAL HOSPITAL OF LARAMIE COUNTY and DePaul Hospital, Appellees (Defendants).

No. 87-22.

Supreme Court of Wyoming.

Sept. 17, 1987.

Rehearing Denied Oct. 7, 1987.

John J. Metzke and Thomas N. Long of Hirst & Applegate, Cheyenne, for appellant.

W. Perry Dray and Gregory C. Dyekman of Dray, Madison & Thomson, P.C., Cheyenne, for appellee Memorial Hosp. of Laramie County.

David H. Carmichael of Carmichael, McNiff & Patton, Cheyenne, for appellee DePaul Hosp.

Jane A. Villemez of Charles E. Graves & Associates, Cheyenne, and Hugh A. Burns of Burns & Figa, P.C., Denver, Colo., filed amicus curiae for the American Society of Dentist Anesthesiologists.

Before BROWN, C.J., and THOMAS, CARDINE, URBIGKIT, and MACY, JJ.

BROWN, Chief Justice.

In this case, we are asked to determine whether a person licensed to practice dentistry in Wyoming ¹ who has special training and experience in the field of general anesthesia, but is not a licensed physician in Wyoming ² is authorized to practice general anesthesiology. We hold that appellant's dental license does not authorize the administration of anesthesia for nondental purposes. We affirm the trial court's order dismissing appellant's complaints, each seeking a declaratory judgment.

On March 28, 1984, appellant Russell F. Paravecchio, D.M.D., applied for an appointment of staff anesthesiologist with privileges appropriate to the full practice of anesthesiology from appellees, Memorial Hospital of Laramie County (Memorial), and DePaul Hospital (DePaul). The Departments of Anesthesiology of Memorial and DePaul jointly reviewed appellant's credentials. Memorial's Executive Committee and also its Board of Trustees both denied appellant's application. Appellant requested and received a review of this denial, pursuant to Memorial's by-laws, before Memorial's Joint Hearing Committee. That committee affirmed the initial decisions denying appellant's application. DePaul's Medical Staff Executive Committee similarly denied appellant's request for anesthesiology privileges.

Appellant filed separate suits against Memorial and DePaul raising two general claims and seeking declaratory judgments for relief: (1) a declaration that Wyoming law currently authorizes a dentist who has successfully completed accredited anesthesiology residency training to legally and independently engage in the professional practice of clinical anesthesiology, and (2) a declaration that the denial of hospital privileges in anesthesiology by the appellee hospitals was impermissible. These complaints were amended on May 7, 1986. Both appellee hospitals filed counterclaims also seeking declaratory judgments that the practice of clinical anesthesiology is the practice of medicine as defined by § 33-26-101, W.S.1977, of the Wyoming Medical Practice Act, and that the hospitals acted properly in denying anesthesiology privileges to appellant.

Appellant filed motions to dismiss both of appellees' counterclaims and both appellees filed motions to dismiss appellant's amended complaints. Motions also were made by both appellees to join the Wyoming Board of Medical Examiners and solely by appellee Memorial to join the Wyoming Board of Dental Examiners as indispensable party defendants. A joint motion to consolidate the two cases was made by all three parties. ³

After a hearing, the trial court ordered that appellant's amended complaints against Memorial and DePaul be dismissed with prejudice, pursuant to Rule 12(b)(6), Wyoming Rules of Civil Procedure, and that the motions made by both Memorial and DePaul to join the Wyoming Board of Medical Examiners as a party to litigation be denied. The effect of the order dismissing appellant's amended complaints was to deny the counterclaims of DePaul and Memorial, neither of which has appealed from that ruling. This appeal followed.

Appellant raises one issue, essentially agreed to by appellees:

"May a documentably competent anesthesiologist practice the full clinical scope of anesthesiology in Wyoming if he or she is licensed by the state of Wyoming as a dentist and is not licensed by the state of Wyoming as a physician."

I

In his first argument, appellant asserts that the scope of dentistry as defined by the Wyoming Dental Practice Act is sufficiently broad to include those procedures necessary in the general practice of anesthesiology by a dentist. He then argues that the delivery of anesthesia may not be considered exclusive to the practice of medicine and therefore, may not be solely limited by the Wyoming Medical Practice Act. We cannot agree.

This case turns on a simple legal question: Does the appellant have the statutory authority in Wyoming to administer general nondental anesthesia under a dental license? Our answer must be based on settled principles of statutory construction. Appellant's extensive arguments regarding his qualifications to practice general anesthesiology are not relevant to this inquiry, and will not be considered.

When interpreting statutes, we must first look to the applicable statute itself giving the words employed by the legislature their plain and ordinary meaning in an attempt to construe legislative intent. City of Evanston v. Robinson, Wyo., 702 P.2d 1283 (1985). We also read statutes relating to the same subject together to effectuate legislative intent. WYMO Fuels, Inc. v. Edwards, Wyo., 723 P.2d 1230 (1986).

Wyoming statutes define the scope of authorized practice for the general field of medicine as well as many specialized areas of practice, including the field of dentistry. ⁴ The Wyoming Dental Practice Act, § 33-15-114, W.S.1977 (1986 Cum.Supp.), states in pertinent part:

"(a) Except as provided by paragraph (xii) of this subsection, any person is deemed to be practicing dentistry within the meaning of this act:

"(i) Who performs, or attempts, or advertises to perform, or causes to be performed by the patient or any other person, or instructs in the performance of any dental operation or oral surgery or dental service of any kind gratuitously or for a salary, fee, money or other remuneration paid, or to be paid, directly or indirectly, to himself or to any other person or agency;

"(ii) Who is a manager, proprietor, operator or a conductor of a place where dental operations, oral surgery or dental services are performed "(iii) Who directly or indirectly by any means or method furnishes, supplies, constructs, reproduces or repairs any prosthetic denture, bridge, appliance or other structure to be worn in the human mouth, or places such appliance or structure in the human mouth or attempts to adjust the same;

"(iv) Who advertises to the public by any method to furnish, supply, construct, reproduce or repair any prosthetic denture, bridge, appliance or other structure to be worn in the human mouth;

"(v) Who diagnoses or professes to diagnose, prescribes for or professes to prescribe for, treats or professes to treat disease, pain, deformity, deficiency, injury to physical condition of human teeth or jaws, or adjacent structure;

"(vi) Who extracts or attempts to extract human teeth, or corrects or professes to correct malpositions of teeth or of the jaw;

"(vii) Who gives or professes to give interpretations or readings of dental roentgenograms;

"(viii) Who administers an anesthetic of any nature in connection with dental operations;

"(ix) Who uses the words 'dentist', 'dental surgeon' or 'oral surgeon', the letters 'D.D.S.', 'D.M.D.' or any other words, letters, title or descriptive matter which in any way represents him as being able to diagnose, treat, prescribe or operate for any disease, pain, deformity, deficiency, injury or physical condition of human teeth or jaws, or adjacent structures;

"(x) Who states or advertises or permits to be stated or advertised by a sign, card, circular, handbill, newspaper, radio or otherwise that he can perform or will attempt to perform dental operations or render a diagnosis in connection therewith; or

"(xi) Who engages in any of the practices included in the curriculum of an approved dental college;

"(xii) A dental laboratory or dental technician is not practicing dentistry within the meaning of this act when engaged in the construction, making, alteration or repairing of bridges, crowns, dentures or other prosthetic or surgical appliances, or orthodontic appliances if the casts or molds or impressions upon which the work is constructed have been made by a regularly licensed and practicing dentist, and if all crowns, bridges, dentures or prosthetic appliances, surgical appliances or orthodontic appliances are returned to the dentist upon whose order the work is constructed." (Emphasis added.)

In § 33-15-128, W.S.1977 (1986 Cum.Supp.), the act further states in pertinent part:

"(a) As used in this act:

" * * *

"(ii) 'Dentistry ' means the healing art practiced by a dentist which is concerned with the examination, diagnosis, treatment, planning and care of conditions within the human oral cavity and its adjacent tissues and structures;

"(iii) 'Dentist ' means a person who performs any intraoral and extraoral procedure required in the practice of dentistry and to whom is reserved:

"(A) The responsibility for final diagnosis of conditions within the human mouth and its adjacent tissues and structures;

"(B) The responsibility of the final treatment plan of any dental patient;

"(C) The responsibility for prescribing drugs which are administered to patients in the practice of dentistry;

"(D) The responsibility for overall quality of patient care which is rendered or performed in the practice of dentistry regardless of whether the care is rendered personally by the dentist or by a dental auxiliary; and

"(E) Other specific services within the scope of the practice of dentistry.

"(iv) 'Dental ' means pertaining to dentistry." (Emphasis added.)

To find that the practice of general nondental anesthesiology is...