Since the late 1800's, a license has been required to practice medicine in New Jersey. The Board, pursuant to the Medical Practice Act of 1894, was authorized to regulate the practice of medicine and surgery, including regulation of chiropractic. Today 12 physicians, one podiatrist, three public members, a certified nurse midwife, a licensed physician assistant, a bioanalytical laboratory director, the Commissioner of Health or his designee and a government liaison member -- all gubernatorial appointees -- serve on the Board (N.J.S.A. 45:9-1, N.J.S.A. 45:1-2.2). Over the past 30 years, the role of the Board has been expanded to involve greater licensing responsibility for numerous and varied allied health providers, and in some instances professions once subject to Board jurisdiction have removed from the ambit of Board responsibility. In 1983 the legislature created a separate Acupuncture Examining Board leaving the Board with only limited responsibility in this field. N.J.S.A. 45:2C-1. That same year a totally independent State Board of Physical Therapy was established, removing physical therapists from the roster of health care professionals under Board oversight. N.J.S.A. 45:9-37.11. Again in 1989 the legislature created a separate State Board of Chiropractic Examiners, transferring the regulation of chiropractic away from the Board. N.J.S.A. 45:9-41.17. At present, in addition to its responsibility to license and discipline physicians, the Medical Board is responsible for overseeing podiatrists, certified nurse midwives, acupuncturists, athletic trainers and bioanalytical lab directors, physician assistants, electrologists, hearing aid dispensers, and perfusionists. While the Board has the responsibility for all of these fields, the administrative tasks relating to physician assistants, electrologists, hearing aid dispensers, and perfusionists are presently being handled by staff in the Newark Division office.
In recent years legislative emphasis has pointed to the recognition that only through more and better information will the public be appropriately safeguarded. A number of issues affecting public protection and licensee discipline have appeared in legislative pronouncements. In 1983, legislation to improve reporting to the Medical Board was passed. One law required health care facilities to notify the Medical Board of any disciplinary proceeding or action resulting in suspension of privileges or removal, or suspension from medical staff. P.L. 1983, c. 247, N.J.S.A. 26:2H-12.2. Another law encouraged voluntary reports of practitioner misconduct to the Medical Board by providing immunity for good faith reports and by assuring confidentiality of any information concerning physician conduct provided to the Medical Board pending the results of an inquiry. P.L. 1983, c. 248, N.J.S.A. 45:9-19.1 to 19.3. Both provisions were strengthened in 1989, upon the passage of the Professional Medical Conduct Reform Act of 1989, sponsored by Senator Richard Codey. In addition, that legislation called for expanded identification of problem professionals, creation of a full-time Medical Director, registration of medical residents in training and practicing in New Jersey prior to licensure, increased licensee information reporting at initial licensure and renewal, authority to require re-education, and monitoring of probation and disciplinary restrictions. P.L. 1989, c. 300, N.J.S.A. 45:9-19.3 to 19.5. One of the most fundamental changes effected by the Professional Medical Conduct Reform Act of 1989 was in the area of malpractice and hospital adverse-action reporting. The legislation created a new recommendatory body, referred to as the Medical Practitioner Review Panel (“Panel”). The Panel was created to enhance the Board’s ability to expeditiously react to reports of malpractice and adverse-privilege actions taken by hospitals The Panel consists of eight members appointed by the Governor -- four physicians, three public members, one hospital administrator -- and one of the members of the Medical Board appointed by the Medical Board President who is to serve in an ex officio capacity. N.J.S.A. 45:9-19.8. The Panel receives notices of hospital or HMO discipline and notices of medical malpractice settlements or judgments.
Other legislative changes included a shift from voluntary reporting of licensee incompetence or impairment presenting imminent danger to the public to mandatory reporting by colleagues. N.J.S.A. 45:9-19.5. Failure to report was made subject to disciplinary action. Existing confidentiality protections were strengthened to provide that information resulting in no action remains confidential. In addition, a full time Medical Director was authorized to review medical malpractice reports and complaints of impairment or incompetence and to assist the Panel. Immunity was provided for good-faith actions taken by the Medical Board or Panel. The law required the Medical Board to provide for registration and permits, and to clearly delineate the scope of practice of practitioners in training. It also required the Medical Board to notify all licensed facilities and associated licensees of formal disciplinary actions taken.
Through other legislative initiatives, since 1990, the Medical Board has been required to notify pharmacists of physicians who are not permitted to prescribe controlled substances. P.L. 1991, c. 304, N.J.S.A. 45:9-16. In the mid 1990's, the Board was given the responsibility to enforce two additional mandates. It must ensure that physicians carry mandatory malpractice insurance (P.L. 1997, c. 365, N.J.S.A. 45:9-19.7), and report out-of-state actions against their medical licenses (P.L. 1995, c. 69, N.J.S.A. 45:9-19.16). In 2002, the Legislature increased required medical training from one year of post-graduate training to two, called for future hiring to provide for an Education Director to serve as liaison to focused re-education programs, required continuing medical education, and authorized the Panel and the Medical Board to refer practitioners to focused re-education. P.L. 2001, c. 307). Most recently, the Board has been charged with the duty to implement a long overdue web-based physician profile (P.L. 2003, c. 96, N.J.S.A. 45:9-22.21), accessible through the Quick Link on this website – New Jersey Health Care Profile.
Each reform has served a laudatory purpose, now allowing the Board to manage and retrieve its licensee data, to better enable the Board to achieve its paramount role of protecting the public.