Ramos vs CA, 380 SCRA 467

Facts:

Petitioner Erlinda Ramos was advised to undergo an operation for the removal of her stone in the gall bladder. She was referred
to Dr. Hosaka, a surgeon, who agreed to do the operation. The operation was scheduled on June 17, 1985 in the De los Santos
Medical Center. Erlinda was admitted to the medical center the day before the operation. On the following day, she was ready
for operation as early as 7:30 am. Around 9:30, Dr. Hosaka has not yet arrived. By 10 am, Rogelio wanted to pull out his wife
from the operating room. Dr. Hosaka finally arrived at 12:10 pm more than 3 hours of the scheduled operation. Dr. Guiterres
tried to intubate Erlinda. The nail beds of Erlinda were bluish discoloration in her left hand. At 3 pm, Erlinda was being wheeled
to the Intensive care Unit and stayed there for a month. Since the ill-fated operation, Erlinda remained in comatose condition
until she died. The family of Ramos sued them for damages.

One of the issues involved was that there was an employee-employer relationship that existed between the medical center and
Drs. Hosaka and Guiterrez.

Ruling:

Private Hospitals hire, fire and exercise real control over their attending and visiting consultant staff. While consultants are not
technically employees, the control exercised, the hiring and the right to terminate consultants fulfill the hallmarks of an
employer-employee relationship with the exception of payment of wages. The control test is determining. In applying the four
fold test, DLSMC cannot be considered an employer of the respondent doctors. It has been consistently held that in determining
whether an employer-employee relationship exists between the parties, the following elements must be present: (1) selection
and engagement of services; (2) payment of wages; (3) the power to hire and fire; and (4) the power to control not only the end
to be achieved, but the means to be used in reaching such an end. The hospital does not hire consultants but it accredits and
grants him the privilege of maintaining a clinic and/or admitting patients. It is the patient who pays the consultants. The hospital
cannot dismiss the consultant but he may lose his privileges granted by the hospital. The hospital’s obligation is limited to
providing the patient with the preferred room accommodation and other things that will ensure that the doctor’s orders are
carried out. The court finds that there is no employer-employee relationship between the doctors and the hospital.