Discipline rate of problem physicians subject of hearing

A report that claims New Jersey is not disciplining enough problem physicians led to a Senate committee hearing Monday.

A report produced by the nonpartisan Public Citizen last month claimed that, among other things, New Jersey is one of 32 states in which more than 50 percent of physicians with complaints logged in a national data bank received no further licensure action at the state level.

The report states that from Sept . 1, 1990, to the end of 2009, N.J. hospitals took disciplinary actions against 320 physicians logged in the National Practitioner Data Bank, yet 57 percent of them – 183 – never had any further state medical board disciplinary action.

The data bank tracks malpractice payouts or disciplinary action against physicians.

“The state medical board has failed to take any action against a large number of its licensed physicians who have been found by New Jersey hospitals to have been unable to practice safely, to have exhibited incompetence, negligence, or substandard/inadequate care or skill levels, or to have engaged in professional misconduct,” Dr. Sidney Wolfe of Public Citizen testified.

The report gave case histories regarding N.J. physicians, without identifying them by name. For example, the report cited a case in which the state board took no further action after a hospital permanently revoked admitting privileges of a physician who had eight malpractice payouts totaling approximately $2.7 million.

Wolfe said that New Jersey’s ranking among the 50 states in terms of disciplinary actions dropped from a high of 18th and 19th in 1993 and 1994 to a low of 41st and 40th in 2008 and 2009.

During his testimony before and subsequent questioning by members of the Senate Health, Human Services and Senior Citizens Committee, he attributed some of the problem to insufficient staffing and funding for the state Board of Medical Examiners, as well as the fact the board does not have a full-time medical director, although it is seeking to staff that position on a part-time basis.

In addition, Wolfe pointed out to the committee that since 1989, the state has had a Medical Practitioner Review Panel that receives reports about problem physicians, does a preliminary investigation, and makes recommendations to the Board of Medical Examiners. He urged the committee to find out how many of the 183 physicians whose cases the Board did not act on were recommended for Board action by the review panel.

He also urged the board to have staff visit other states that he believes are doing the job well.

Wolfe said that at one time, Arizona ranked 38th in the nation, but after devoting more resources to the problem, tripled their rate of disciplinary actions within three years, and that Colorado does not have as many staff as some states but has consistently ranked high in disciplinary action.

Lawmakers expressed concern regarding the report’s findings.

During the hearing, committee chairwoman Sen. Loretta Weinberg, (D-37), Bergen, said it was important to make sure that they were comparing apples to apples when comparing enforcement actions among states.

“I am concerned about the staffing levels,’’ she said of the N.J. Board.

“We need to make sure that the Board has the tools it needs to pursue cases of suspected wrongdoing, and to make sure doctors and other health care professionals are held to the highest professional standards,” she said  after the hearing.

But Lawrence DeMarzo, of the N.J. Division of Consumer Affairs, told the committee that while they respect Wolfe as a watchdog, they disagree with his findings.

“In our view, the notion that the Board should publicly discipline every physician reflects a basic misunderstanding of the various functions of the Board,’’ he said.  

“Remediation,’’ he said, “often returns a competent physician to practice who is no threat to public safety.’’

The report said that some ‘serious’ offenders went undisciplined.

“Public Citizen used the term ‘serious.’ Our point is that regardless of the definition, in raw numbers, each and every report was carefully reviewed and appropriately handled in the judging by the panel,” DeMarzo  testified. “The public  should have confidence that their interests are well protected.”

No action was taken by the Senate committee; the hearing was held to gather information on the situation. Discipline rate of problem physicians subject of hearing