A recently decided case, In the Matter of the License of Pemberton, M.D., is an example of the deference New Jersey courts give to decisions made by the New Jersey State Board of Medical Examiners. On June 10, 2024, the New Jersey Appellate Division upheld the Board’s decision to suspend a doctor’s license after he tested positive for illegal substances during a failed remediation plan, finding the Board’s decision to be well-reasoned and supported by substantial credible evidence as a whole. Given the doctor’s systemic use of illegal substances coupled with several positive blood and urine tests, the Appellate Division agreed that the Board did not have to wait for the doctor to cause harm to a patient before it suspended his license because the evidence clearly demonstrated that as the doctor was using illegal substances, his ability to practice medicine was likely to be impaired.
This case brings awareness to doctors, who should know that the Board has the power to suspend or revoke a doctor’s license if the doctor engages in drugs or uses alcohol within the previous 365 days in a manner likely to impair his/her ability to practice medicine with reasonable skill and safety. N.J.S.A. 45:1-21(1). Doctors should also be aware that the Board’s authority is broad enough to revoke a medical license if the doctor poses a risk of harm to the next patient. Simply stated, the Board need not wait until the doctor causes harm before taking action.
Additionally, this case highlights remedial action plans that hospitals can take to rehabilitate complaints related to a medical staff member’s conduct and poor quality of care if it stems from purported substance abuse. The hospital can place the doctor on a remediation plan that could include a referral to the Professional Assistance Program of New Jersey (PAP). The PAP works in tandem with the Board’s Impairment Review Committee (IRC) by providing services to doctors with chemical dependencies or other impairments. It is authorized by statute to enter into letter agreements with these doctors detailing their plan for recovery and each doctor’s obligations. Therefore, hospitals must also be aware that the PAP is obligated to report immediately the identity of any doctor that has not complied with the terms of this letter agreement, and to report to the IRC if that doctor has tested positive for the presence of a substance that was not appropriately prescribed for a legitimately documented reason, or if the doctor demonstrates a relapse. This is a separate avenue from the hospital’s corrective action, collegial intervention, or summary suspension.
Courts will only reverse the Board’s decision if it was arbitrary, capricious, or unreasonable or, if it was not supported by substantially credible evidence. The Appellate Division evaluated the Board’s decision using the following three criteria to determine whether the Board’s decision should be given substantial deference:
- whether the Board followed the law;
- whether the record contained substantial evidence to support the Board’s decision; and
- whether the Board’s decision was clear error because the conclusion could not have reasonably been made based on the relevant facts.
Ultimately, the Appellate Division found no merit in the doctor’s arguments that the State failed to demonstrate proof that he was impaired and determined that the Board’s thorough and well-reasoned decision was supported by the record. Read together, New Jersey courts will not disturb well-reasoned administrative decisions unless the decision is shown to be arbitrary and capricious. Here, it was not.
