Oversight of Physicians' Conduct by State Licensing Agencies
Authors: Norton Spritz
Journal: Annals of Internal Medicine (1991)

Medicine and Public Issues1 August 1991Oversight of Physicians' Conduct by State Licensing AgenciesLessons from New York's Libby Zion CaseNorton Spritz, MD, JDNorton Spritz, MD, JDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-115-3-219 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe unexplained and highly publicized death of an 18-year-old woman in a New York Hospital in 1984 became the focus for debate throughout the country concerning working conditions and supervision of house officers. It also led to charges by the State of New York of gross negligence against her resident physicians. The residents were exonerated of all charges by a review panel with lay and physician representation after testimony of expert witnesses. Although the Commissioner of Health concurred with this verdict, residents were charged with gross negligence by the Board of Regents, a lay panel. Fundamental contrasts in the way the two panels made their judgments supports the importance of peer review in disciplining physicians in matters of medical judgment. Analysis of the actions by New York State against the residents also underscores the importance of other principles in the oversight of physician behavior that are applicable to all jurisdictions: resolution of charges without undo delay, an equitable and consistent standard for the administration of sanctions, and adherence to a clearly defined standard for the level of culpability required for disciplinary action. Both the structure of the review process and its application in this instance led to violations of each of these principles....References1. AschParker DR. The Libby Zion case. One step forward or two steps backward? N Engl J Med. 1988;318:771-5. CrossrefMedlineGoogle Scholar2. New York State Public Health Law, Section 230. Google Scholar3. New York State Education Law, Sections 6509(2) and 6510. Google Scholar4. New York State Department of Health; State Board for Professional Medical Conduct, Report of the Hearing Committee, 31 August 1989: 59. Google Scholar5. New York State Public Health Law, Section 405a. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Norton Spritz, MD, JDFrom the Department of Veterans Affairs Medical Center, New York, and the New York University School of Medicine, New York, New York. For the current author address, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byViolations and Medication SafetyLegal IssuesThe Leadership Style of "The People's Doctor": A Contemporary Look Back at New York State Commissioner of Health David Axelrod, MDRegulations of Night Shifts of Pediatric Residents: Review of Responses to a European SurveyDuty hours restriction for our surgical trainees: An ethical obligation or a bad idea?Simulation Training Experience in Neurosurgical Training in EuropeDetermining Resident Sleep During and After Call With Commercial Sleep Monitoring DevicesThe 2016 AANS Presidential Address: Leading the wayEvidence-Based Practice and Policy: ACGME Resident Duty Hours—More Harm Than HelpSerotonin SyndromeThe '16-Hour Rule': A Giant Step, But in which Direction?Nonbeneficial CareFacing Our FailuresReflections on Competency-Based Education and Training for Surgical ResidentsThree-Year Experience with an Innovative, Modular Competency-Based Curriculum for Orthopaedic TrainingToronto Orthopaedic Boot Camp III: Examining the efficacy of student-regulated learning during an intensive, laboratory-based surgical skills courseDuty-Hour Limits and Patient Care and Resident Outcomes: Can High-Quality Studies Offer Insight into Complex Relationships?Resident duty hour standards and recommendations for intensive care unit staffing: White paper or black box?*Agents of ChangeGeneral Surgery Residents' Views on Work Hours RegulationsImpact of ACGME Work-Hour Restrictions on the Outcomes of Coronary Artery Bypass Grafting in a Cohort of 600,000 PatientsPhysicians and Sleep DeprivationPhysicians and sleep deprivationInvited Commentary: How Much Do We Really Sleep?Who says you're too tired? *The Libby Zion CaseRobin L. Kaplan, MD 1 August 1991Volume 115, Issue 3Page: 219-222KeywordsBehaviorPeer review ePublished: 1 December 2008 Issue Published: 1 August 1991 PDF downloadLoading ...