Letter to the Editor
The Medical Society of New Jersey (MSNJ) takes the issue of physician discipline quite seriously. In fact, the MSNJ Judicial Council resolves many disputes and complaints each year filed against physician members.
We appreciate the attention brought to this issue each year by Public Citizen and Dr. Sidney Wolf. Public Citizen regularly releases the same report year after year and we respond the same way each year. As we understand the methodology, the report does not include private letter agreements represent a significant amount of the disciplinary activity in NJ. Under a private letter agreement, prosecutors defer a formal license action in lieu of fines and additional training for certain infractions or first time issues or cases where a prosecutor has limited evidence, but enough to proceed against the licensee. The nature of a private letter agreement is that it is non-disclosed, thus not available for researchers to count. This gives NJ a lower ranking.
Don’t be fooled into thinking a private letter agreement is not a significant penalty or does not work to protect the public. For example, under a garden variety private letter agreement the disciplinary action may include fines, mandatory additional training (at the physician’s expense) and hiring a practice monitor to comply with the terms of the discipline. In addition, competency evaluations and personalized educational programs may also be ordered. Finally under a private letter agreement if any of the conditions are not met by the physician within the specified time frames an automatic license suspension can result.
If the researchers had actually interviewed state boards and factored this type of discipline into the report, Public Citizen might have produced a more accurate and useful study.