This appeal arises from a medical malpractice action filed in the Health Claims Arbitration Office (“HCAO”).
See
Maryland Code (1973, 1995 Repl.Vol. & Cum.Supp.), §§ 3-2A-01 et seq. of the Courts and Judicial Proceedings Article (“the Health Care Malpractice Claims Act” or “the Act”). The issue we must decide is whether the petitioners, Kenneth M. Goodwich, M.D. and Kenneth M. Goodwich, M.D., P.A. (hereinafter “the petitioners” or “Dr. Goodwich”), properly instituted a mandamus action in the Circuit Court for Baltimore City to obtain judicial review of a HCAO discovery order compelling deposition testimony concerning the findings and recommendations of a medical review committee. The circuit court denied the petitioners’ request for mandamus relief. On appeal, the Court of Special Appeals affirmed the judgment of the circuit court.
Goodwich v. Nolan (“Goodwich I”),
I.
The medical malpractice action out of which this case arose was initiated by Sharon Brooks, individually and as parent, guardian, and next friend of her son, Jamaal Brooks, in the Health Claims Arbitration Office, against Dr. Goodwich, Sinai Hospital of Baltimore, Inc. (“Sinai Hospital”), Health Care Corporation of the Mid-Atlantic (“Carefirst”), and Potomac Physicians, P.A. (“Potomac”) for alleged negligent surgical and obstetrical care resulting in Jamaal’s birth, in December 1988, with severe brain damage. In addition to claims of primary *136 medical negligence against Dr. Goodwich, vicariously imputed to the other health care providers, Ms. Brooks also brought claims of corporate liability against Sinai Hospital, Carefirst and Potomac based on theories of negligent supervision and credentialing. Paul W. Nolan, Esquire, the respondent (“the panel chair”), the chair of the arbitration panel assigned to the case, later bifurcated the latter claims.
While in the discovery phase of the HCAO proceeding, Ms. Brooks deposed Dr. Goodwich and two former Sinai Hospital employees, Rebecca Brown, R.N., and Dr. Mary Anne Lathrop, both of whom had been involved in Ms. Brooks’s care. During Dr. Goodwich’s deposition, Ms. Brooks’s attorney asked a series of questions regarding alleged disciplinary restrictions imposed on Dr. Goodwich’s staff privileges at Sinai Hospital, including, inter alia, whether he was “required at Sinai Hospital to obtain second opinions for patients,” 1 whether his medical license ever had been suspended, revoked or curtailed, in any way, while Ms. Brooks was his patient, and whether he ever had been discharged from Sinai’s HMO. Ms. Brooks’s attorney also questioned Dr. Goodwich about alleged communication problems with other patients.
Dr. Goodwich refused to answer this line of questioning, contending that it infringed upon the protections of the medical peer review privilege as set forth in Maryland Code (1981, 1994 Repl. Vol, 1995 Cum.Supp.), § 14-501(d) of the Health Occupations Article. That section provides, in pertinent part:
[T]he proceedings, records, and files of a medical review committee are not discoverable and are not admissible in evidence in any civil action arising out of matters that are being reviewed and evaluated by the medical review committee. 1 - 2 ' 1
*137 Ms. Brooks’s attorney asked Ms. Brown and Dr. Lathrop similar questions in their subsequent depositions. They were asked whether they knew if Dr. Goodwich’s privileges had been suspended or curtailed, in any way, while he was caring for Ms. Brooks, and whether they knew if Dr. Goodwich had been required to obtain second opinions. Like Dr. Goodwich’s attorney, and for the same reason, the attorney for Sinai Hospital instructed Ms. Brown and Dr. Lathrop not to answer the questions.
Dr. Goodwich and Sinai Hospital having raised claims of privilege, Ms. Brooks’s attorney filed a motion with the panel chair to compel the deponents to answer the questions. After reviewing the briefs submitted by Ms. Brooks and Dr. Goodwich, the panel chair, in an order issued on June 22, 1993, granted Ms. Brooks’s motion.
3
The order stated the basis for
*138
his decision, namely his belief, given the authorities submitted, that the information Ms. Brooks sought did not constitute the “ ‘proceedings, records, and files of a medical review committee[,]’ ” (quoting § 14-501(d)(1)). The panel chair concluded, therefore, that § 14-501(d)(1) did not preclude discovery of the information. While noting that there were no Maryland appellate cases directly addressing the issue, the panel chair, nevertheless, was persuaded by the analysis adopted by the Supreme Court of Rhode Island in
Moretti v. Lowe,
Dr. Goodwich filed a motion for reconsideration of the panel chair’s discovery order. The motion was denied. Meanwhile, Ms. Brooks having filed another motion to compel him to appear for a supplemental deposition, Dr. Goodwich filed a motion for a protective order asking the panel chair to stay all discovery while he pursued mandamus relief in the Circuit Court for Baltimore City. The panel chair granted the motion and ordered all discovery stayed for 60 days to allow Dr. Goodwich to seek mandamus relief.
Thereafter, Dr. Goodwich filed, in the circuit court, a Verified Complaint Seeking Writ of Mandamus, naming the panel *139 chair and the HCAO, through its director, Walter R. Tabler 6 , as defendants. In that complaint, he sought to have the court prevent the panel chair and/or the HCAO from “compelling production of statutorily privileged medical peer review information in violation of Maryland law.” The panel chair and Mr. Tabler filed a motion to dismiss Dr. Goodwich’s mandamus action, arguing that mandamus will not lie when a fully adequate statutory remedy is available after the HCAO makes a final award, that Dr. Goodwich’s complaint was interlocutory, and that mandamus relief is inappropriate to direct a party to exercise judgment that is discretionary. The circuit court granted the motion, adopting as the reasons for the dismissal, those enumerated in the defendants’ motion to dismiss.
Following the circuit court’s dismissal of his complaint, Dr. Goodwich appealed to the Court of Special Appeals.
7
That court, as previously noted, affirmed the judgment of the circuit court.
Goodwich v. Nolan, supra,
II.
A.
Dr. Goodwich asserts that the test for assessing the propriety of issuing a writ of mandamus during an ongoing HCAO proceeding is “ ‘where there is no other available procedure for obtaining review,
or
where the action complained of is arbitrary and capricious[,]’ ” (quoting
Goodwich I, supra,
In Dr. Goodwich’s view, vacating an ultimate HCAO award would fail to protect privileged peer review information from initial disclosure during discovery. Thus, he claims that once privileged information is produced in discovery, its confi *141 dentiality is forever compromised, rendering any post-arbitration motion to vacate the award insufficient to redress the wrong. Furthermore, he claims that the use of a protective or seal order would, at best, limit the degree to which peer review confidentiality would be compromised, but would not prohibit the disclosure of the confidential information to Ms. Brooks, or its subsequent review and use by her to pursue her claims. For these reasons, Dr. Goodwich contends that mandamus is the only adequate procedural vehicle available to him by which to obtain effective judicial review of the disputed discovery order. Moreover, he asserts that the circuit court’s exercise of mandamus jurisdiction during an HCAO proceeding is consistent with Maryland’s application of the collateral order doctrine. 8
*143
Alternatively, Dr. Goodwich argues that, even if this Court were to conclude that he has an adequate remedy other than mandamus, such as judicial review of the HCAO award, it still must review the panel chair’s decision for the presence of “ ‘arbitrary, capricious, unreasonable or illegal actions taken by the [sic] inferior tribunal[,]’ ” (quoting
Dorchester General Hospital v. Sober,
B.
Ms. Brooks sees matters quite differently. Her opinion, as was the Court of Special Appeals’s, is that judicial review is available to Dr. Goodwich only upon the completion of the HCAO arbitration proceeding. At that time, she submits, he could seek to have the arbitration award vacated. She further echoes the intermediate appellate court’s view of the matter by arguing that Dr. Goodwich could have sought a protective order to safeguard what he deemed to be confidential informa *144 tion. She also asserts that mandamus is not justified in this case under the collateral order doctrine because, inter alia, the discovery order did not conclusively resolve any aspect of the arbitration proceeding and because the order is not distinct from the merits of the case. 9
In this case, Ms. Brooks asserts, the underlying discovery decision involved an exercise of discretion; the panel chair was required first to decide whether to compel discovery, see Maryland Rule 2-432, and upon deciding to compel discovery, to ' choose the appropriate sanction, in the event of noncompliance. See Maryland Rule 2-433. For this reason, then, she contends that mandamus does not he. Also, Ms. Brooks rejects Dr. Goodwich’s claim that the panel chair acted arbitrarily. On the contrary, she says that he exercised appropriate judgment and discretion in concluding that the information she sought did not constitute the “proceedings, records and files of a medical review committee.” She thus argues that, rather than to shield the subject(s) of peer review discussions, Maryland’s peer review statute, like that of many other states, was designed to provide immunity from liability for those person who give information to, participate in, or contribute to the functioning of a medical review committee. 10
*145 III.
A.
We begin our analysis in this case with a brief review of the common law writ of mandamus. “Mandamus is an original action, as distinguished from an appeal.” 52 Am.Jur.2d
Mandamus
§ 4 (1970) (footnote omitted). It is “not a substitute for appeal or writ of error.”
In re Petition for Writ of Prohibition,
In its opinion, the Court of Special Appeals states that “[mjandamus is ... reserved only for those instances ‘where there is no other available procedure for obtaining review,
or
where the action complained of is arbitrary and capricious.’ ”
Goodwich I, supra,
This Court has stated that judicial review is properly sought through a writ of mandamus “where there [is] no statutory provision for hearing or review
and
where public officials [are] alleged to have abused the discretionary powers reposed in them.”
11
State Department of Health v. Walker,
Our mandamus jurisprudence is illustrated both by those cases in which we have granted the writ, as well as those in which we have refused to issue it. For example, in
Maryland-National Capital Park and Planning Commission v. Rosenberg,
In
Bovey, supra,
the petitioners sought a writ of mandamus to compel the Director of the HCAO to inquire of potential arbitration panelists whether they had an economic relationship with the health care providers whose cases they would be deciding. We denied relief on the basis that the Director was free to exercise discretion in assuring the impartiality of panelists; therefore, mandamus would not lie to compel him to follow a specific procedure.
B.
Having thus articulated the appropriate rule of law, we proceed to the substance of Dr. Goodwich’s claims. Because Dr. Goodwich’s refusal to comply with the panel chair’s discovery ruling rests on a claim of privilege, he contends that mandamus provides him the only available procedural avenue for effective judicial review of the order. We disagree. To be sure, as we have seen, courts have the right to review the discretionary decisions reached in quasi-judicial proceedings for arbitrariness, illegality or capriciousness.
Maryland Aggregates Association v. State,
In the instant case, the Act represents a comprehensive statutory scheme, adopted by the General Assembly in 1976 as part of Maryland’s response to the medical malpractice insurance crisis.
Tabler, supra,
Therefore, it is foreseeable that, in the course of resolving discovery disputes, panel chairs will be called upon to consider, and settle, matters involving privileges. Thus, the Legislature’s decision to prescribe, as part of the statutory scheme, that judicial review occur
after
a final HCAO decision is reached evinces, as the Court of Special Appeals observed,
see Goodwich I, supra,
Requiring that HCAO proceedings be final before a party to them may obtain judicial review is likewise consonant with the exhaustion of administrative remedies doctrine, which states that, with rare exceptions, one cannot seek judicial review until a final administrative decision is reached.
See, e.g., Montgomery County v. Ward,
Having already determined it to be ill-founded, we need not further address Dr. Goodwich’s argument that even if we find that he has an adequate statutory remedy, we must still review the panel chair’s discovery ruling for the presence of
*152
arbitrary, capricious or unreasonable action. We also decline, as did the Court of Special Appeals, to address the substantive issue of whether the ultimate findings and conclusions of a medical review committee are privileged under § 14 — 501(d)(1).
Goodwich I, supra,
Like the Court of Special Appeals, we believe that Dr. Goodwich had other options open to him, short of mandamus, to protect what he believed to be privileged peer review information. Specifically, he could have sought a protective order requesting that certain matters not be inquired into, or limiting who had access to the information, or requesting that the scope of discovery be limited. See Maryland Rule 2-403. That rule is applicable in health claims arbitration proceedings pursuant to § 3-2A-05(b)(2) of the Courts and Judicial Proceedings Article. It states, in part, “[e]xcept for the provisions of the Maryland Rules relating to time for the completion of discovery, the provisions of the Maryland Rules relating to discovery are applicable to proceedings under this subtitle.” In addition, he also could have asked the court to place the depositions under seal pursuant to § 2-403(a)(7). 16
*153 C.
Although we have concluded that mandamus relief is inappropriate in this case, we pause momentarily to address the issue of the applicability of the collateral order doctrine to the writ of mandamus. The Court of Special Appeals apparently assumes that, to qualify for judicial review in the circuit court, Dr. Goodwich’s mandamus petition must have satisfied the requirements of the collateral order doctrine.
See Goodwich, supra,
The collateral order doctrine was first recognized by the United States Supreme Court in
Cohen v. Beneficial Indus. Loan Corp.,
*154
The collateral order doctrine permits the prosecution of an appeal from certain interlocutory orders. Mandamus, on the other hand, as we stated earlier, is not a vehicle for prosecuting an appeal. While it involves judicial review of orders passed by courts and administrative agencies and the actions of public officials,
see Gould, supra,
Although the purpose of the mandamus action was to review the panel chair’s discovery decision, the appellant initiated a separate and independent mandamus action in the circuit court. That action was fully decided in that court. And because, with respect to the propriety of the issuance of the writ of mandamus, it settled, determined, and concluded the rights of the parties involved in that action, thus terminating the cause of action,
Estep v. Georgetown Leather,
JUDGMENT AFFIRMED, WITH COSTS.
Notes
. This question, we presume, was intended to elicit whether Dr. Goodwich had been required to obtain second opinions regarding proper patient care.
. At Sinai Hospital, and similar health care institutions, the decisions regarding the revocation, suspension or extension of a physician’s staff privileges are made and enforced by a committee of medical profession *137 als encompassed within the definition of a "medical review committee.” Maryland Code (1981, 1994 Repl.Vol., 1995 Cum.Supp.), § 14-501(b)(5) of the Health Occupations Article, defines a “medical review committee” as:
A committee of the medical staff or other committee, including any risk management, credentialing, or utilization review committee established in accordance with § 19-319 of the Health General Article, of a hospital, related institution, or alternative health care system, if the governing board of the hospital, related institution, or alternative health care system forms and approves the committee or approves the written by laws under which the committee operates ....
Section 14-501(c) prescribes the functions of a medical review committee:
(1) Evaluates and seeks to improve the quality of health care provided by providers of health care;
(2) Evaluates the need for and the level of performance of health care provided by providers of health care;
(3) Evaluates the qualifications, competence, and performance of providers of health care; or
(4) Evaluates and acts on matters that relate to the discipline of any provider of health care.
. The panel chair’s authority to resolve discovery disputes is derived from Maryland Code (1973, 1995 Repl.Vol. & Cum.Supp.), § 3-2A-05(c) of the Courts and Judicial Proceedings Article. That section provides, in pertinent part:
The attorney member of the panel shall be chairman and he shall decide all prehearing procedures including issues relating to discovery and motions in limine.
. In
Moretti v. Lowe,
. Shortly after the panel chair issued the order compelling the production of the discovery information, Ms. Brooks reached a settlement of her claims with Sinai Hospital. Therefore, Sinai was dismissed from the case and is not a party to these proceedings.
. Mr. Tabler, who retired as HCAO Director subsequent to the institution of this litigation, was replaced by Henry J. Raymond, the interim Director. The present Director, Harry L. Chase, was subsequently joined as a party. The issue of the appropriateness of the joinder of the HCAO Director was not raised by the petitioner in this Court, and consequently, we do not consider it.
. Ms. Brooks was not a named defendant in the circuit court action. She moved to intervene in the proceedings after the circuit court dismissed the mandamus action.
. The collateral order doctrine is an exception to the final judgment rule.
Public Service Commission
v.
Patuxent Valley,
“(1) it must conclusively determine the disputed question;
(2) it must resolve an important issue;
(3) it must be completely separate from the merits of the action; and
(4) it must be effectively unreviewable on appeal from a final judgment.”
Montgomery County v. Stevens,
Dr. Goodwich’s argument that the exercise of mandamus jurisdiction during pending HCAO proceedings is consistent with the collateral order doctrine focuses primarily on the fourth of that doctrine's prerequisites, upon which he heavily relies. He submits that, unless the ruling is reviewed on mandamus, disclosure of the privileged information already will have occurred when his right to judicial review will have matured, rendering that right inadequate. Dr. Goodwich's reliance is misplaced.
In Maryland, “discovery orders, being interlocutory in nature, are not ordinarily appealable prior to a final judgment terminating the case....”
Montgomery County, supra,
Also, in the usual case, the party or individual opposing the discovery order does not suffer sufficient immediate harm to warrant an appeal prior to the final termination of the litigation. Moreover, a party is generally able to seek effective review of the order upon an appeal from an adverse final judgment terminating the case.
Id.
at 208,
This Court has also recognized a rule enunciated by the United States Supreme Court in
Alexander v. United States,
[Ojnly an appeal from a contempt order, as opposed to an order to produce documents pursuant to the subpoena [or, as in this case, to answer deposition questions], is final enough and separable enough from the merits to confer the power of review on an appellate court.
In the case
sub judice,
Dr. Goodwich's argument that, without mandamus, review following the entry of a final order terminating the action will be ineffective, is premised upon there being a necessity for a different rule when the issue which is the subject of the discovery order involves the applicability of a statutory privilege. We are not persuaded. In our opinion, the nature of the information sought to be discovered does not change the analysis. Whatever its nature, a party aggrieved has the means of obtaining review in advance of the final judgment, albeit it may involve subjecting him or herself to a contempt citation. Any other result would undermine the purpose of the finality rule to prevent piecemeal appeals and the interruption of ongoing judicial
*143
proceedings.
See Sigma Repro. Health Center, supra,
. We note that Ms. Brooks, and the State, responding on behalf of the panel chair, both assert that Dr. Goodwich’s commencement of litigation against Sinai Hospital, in which he claimed to be aggrieved by the restrictions the Medical Executive Committee imposed on his staff privileges,
see Goodwich v. Sinai Hospital,
. In its brief submitted on behalf of Mr. Nolan, the State raised essentially the same counter-arguments as did Ms. Brooks; therefore, we will not treat them separately here.
. The Court further stated that "[d]ecisions contrary to law or unsupported by substantial evidence are not within the exercise of sound ... discretion, but are arbitrary and illegal acts.”
State Department of Health
v.
Walker,
. Although this principle is not presently adhered to by the Court of Special Appeals, it is one that the court formerly recognized. In
Prince George’s County v. Carusillo,
. As first enacted, it was contemplated, and, therefore, the Health Claims Arbitration Act, Maryland Code (1973, 1995 Repl.Vol. and Cum.Supp.), §§ 3-2A-01 et seq. of the Courts and Judicial Proceedings Article, provided that medical malpractice claims must be arbitrated. See ch. 235, Acts of 1976. The Act was amended in 1987 to permit the parties to “agree mutually to waive arbitration.” See ch. 596, Acts of 1987, adding § 3-2A-06A.
Effective October 1, 1995, the Act was again amended with respect to waiver, see ch. 582, Acts of 1995, this time to add a new § 3-2A-06(B). Subsection (a) of that section provides:
In general. — Arbitration of a claim with the Health Claims Arbitration Office may be waived by the claimant or any defendant in accordance with this section, and the provisions of this section shall govern all further proceedings on any claim for which arbitration has been waived under this section.
This provision is prospective only, applying to those claims arising after October 1, 1995. As a result of this amendment, waiver of arbitration no longer requires the mutual agreement of the parties; it may be accomplished unilaterally, by either the claimants) or defendant(s), after the claimant has filed the certificate of qualified expert required by § 3-2A-04(b).
. Once the HCAO renders a final award, judicial review may be instituted under § 3-2A-06 of the Courts and Judicial Proceedings Article. First, the rejecting party must file a notice of rejection with the Director and the arbitration panel within a specified time. Subsection (a). In addition, the rejecting party must file an action in circuit court to nullify the award. Subsection (b). If, however, the rejecting party also seeks, on specified grounds, to modify, correct or vacate the award, or the assessment of costs, a preliminary motion must be filed pursuant to § 3-2A-06(c). That section provides, in pertinent part:
(c) Modification, correction, or vacation of award or assessment of costs by court. — An allegation by any party that an award or the assessment of costs under an award is improper because of any ground stated in § 3-223(b) or § 3 — 224(b)(1), (2), (3), or (4) or § 3-2A-05(h) of this article shall be made by preliminary motion, and shall be determined by the court without a jury prior to trial. Failure to raise such a defense by pretrial preliminary motion shall constitute a waiver of it. If the court finds that a condition stated in § 3-223(b) exists, or that an award was not appropriately modified in accordance with § 3-2A-05(h) of this subtitle, it shall modify or correct the award or the assessment of costs under an award. If the rejecting *150 party still desires to proceed with judicial review, the modified or corrected award shall be substituted for the original award. If the court finds that a condition stated in § 3-224(b)(1), (2), (3), or (4) exists, it shall vacate the award, and trial of the case shall proceed as if there had been no award.
Section 3-224(b) of the Courts and Judicial Proceedings Article, incorporated by reference into § 3-2A-06(c), also applies in HCAO matters and provides that an arbitration award may be vacated, inter alia, on the following grounds:
(1) An award was procured by corruption, fraud, or other undue means;
(2) There was evident partiality by an arbitrator appointed as a neutral, corruption in any arbitrator, or misconduct prejudicing the rights of any party;
(3) The arbitrators exceeded their powers;
(4) The arbitrators refused to postpone the hearing upon sufficient cause being shown for the postponement, refused to hear evidence material to the controversy, or otherwise so conducted the hearing ... as to prejudice substantially the rights of a party....
. Those of our sister jurisdictions that have decided this issue have reached differing conclusions. Some courts have held that the findings and recommendations of peer review committees are within the purview of the privilege.
See, e.g., Beth Israel Hospital v. District Court,
. Maryland Rule 2-403(a) provides, in pertinent part:
(a) Motion. — On motion of a party or of a person from whom discovery is sought, and for good cause shown, the court may enter any order that justice requires to protect a party or person from annoyance, embarrassment, oppression, or undue burden or expense, *153 including one or more of the following: ... (5) that certain matters not be inquired into or that the scope of discovery be limited to certain matters, (6) that discovery be conducted with no one present except persons designated by the court, (7) that a deposition, after being sealed, be opened only by order of the court....
