The Doctor Discipline Crisis in New Jersey
Statement by Sidney Wolfe, M.D., Director of Public Citizen’s Health Research Group
Jan. 31, 2003
For more than 10 years, Public Citizen’s Health Research Group has ranked state medical boards based on the rate of serious disciplinary actions (revocation, suspension, surrender and probation) per 1,000 doctors in the state. For five of the past ten years (four of the past five years) New Jersey has ranked in the bottom half of all states, and in 2001, the last year for which data are available, it ranked 23rd. The rate of serious actions in 2001 – 3.53 per 1,000 physicians – is barely more than one-third of the rate in Arizona, which is first in the country with 10.52 serious actions per 1,000 physicians.
This poor showing in overall disciplinary rate is reflected in the similarly poor performance of the New Jersey medical board in taking disciplinary actions against the 135 New Jersey physicians who, according to data from the federal National Practitioner Data Bank (NPDB), have had five or more malpractice payouts against them between September 1990, when the NPDB began operation, and September 2002. Not only are most of them still practicing, but only 27 of these physicians (20 percent) have had any disciplinary actions taken against them. The other 108 physicians, in the 12 years since the data bank started, have had no disciplinary actions by the medical board despite having had five or more malpractice payouts against them.
Given that the New Jersey medical board, unlike patients and physicians, has access to the data in the NPDB, it is inexcusable that it has failed to take away the licenses or even discipline more of these physicians who are doing so much damage to patients and causing so many malpractice payouts.
New Jersey physicians have not, to our knowledge, launched a major campaign to strengthen the New Jersey medical board in an effort to better protect patients from this small fraction of New Jersey physicians who are doing an inordinate amount of damage to their patients. Instead, in what is a smokescreen to obscure the doctor discipline crisis, they are planning to further punish patients by the unethical strikes planned for next week in order to get a cap on non-economic damages passed in the state legislature.
A Planned Unethical Strike by New Jersey Physicians
The AMA Code of Medical Ethics: Current Opinions with Annotations reflects the application of the Principles of Medical Ethics. An opinion, E-9.025, Collective Action and Patient Advocacy, which went into effect in December 1998, states that “Collective action should not be conducted in a manner that jeopardizes the health and interests of patients…Strikes reduce access to care, eliminate or delay necessary care, and interfere with continuity of care. Each of these consequences is contrary to the physician’s ethic. Physicians should refrain from the use of the strike as a bargaining tactic.”1
Although confirming the rights of physicians to organize and stating that
“There are some measures of collective action that may not impinge on essential patient care,” the planned New Jersey strike by doctors clearly violates the AMA ethical code even though stating that physicians will provide “emergency ” care. Essential patient care cannot be construed to mean only emergency care. The fact that this strike has the blessing of the New Jersey State Medical Association, with its close affiliation with the AMA, makes matters even worse.
1. http://www.ama-assn.org/apps/pf_online/pf_onlinef_n=browse&doc=policyfiles/CEJA/E-9.025.HTM&&s_t=&st_p=&nth=1&prev_pol=policyfiles/CEJA/E-8.21.HTM&nxt_pol=policyfiles/CEJA/E-9.01.HTM (accessed 1/30/03)