## Facts

- Dr. Italo J. Falcone held an unrestricted New Jersey license to practice medicine and surgery after completing osteopathic medical training, residency, and passing the state medical examination.
- He later earned an M.D. from the University of Milan.
- The Middlesex County Medical Society initially accepted Falcone as an associate member (1953) but later denied him full membership (1956), ending his associate status.
- The Society relied on an unwritten requirement that members must have four years of study at an American Medical Association (AMA)-approved medical school; Falcone allegedly did not satisfy that requirement.
- Local hospitals conditioned staff privileges on membership in the county medical society, so denial of Society membership effectively barred Falcone from hospital-based practice, including surgery and obstetrics, in the county.
- After unsuccessful efforts within professional organizations, Falcone sued to compel admission; the trial court ordered the Society to admit him, and the Society appealed.

## Issues

1. Whether a county medical society that effectively controls access to local hospital staff privileges may exclude a duly licensed physician based on an unwritten AMA-approved school attendance requirement.
2. Whether, and to what extent, courts may review and set aside a private professional association’s membership decisions when exclusion materially impairs the ability to practice a profession and earn a livelihood.

## Decision

- The New Jersey Supreme Court affirmed the order requiring the Society to admit Falcone to full membership.
- The Court held the Society’s exclusion of Falcone, based on an unwritten educational criterion, was arbitrary, unreasonable, and contrary to public policy.
- The Court concluded judicial relief was warranted because the Society’s membership decision operated as a gatekeeping mechanism for hospital practice in the county.

## Legal Principles

- When a private professional association’s membership decisions have substantial public and economic consequences—such as controlling meaningful access to hospital facilities—courts may review those decisions for reasonableness and consistency with public policy.
- Exclusionary criteria that are unwritten, nontransparent, or applied ad hoc, and that lack a rational connection to competence, ethics, or public protection, may be set aside as arbitrary.
- A professional association exercising monopoly-like power over a segment of professional practice may not use membership rules primarily functioning to restrict competition rather than protect patients or professional standards.
- Where exclusion causes serious impairment of professional practice and the decisionmaking standard is unreasonable, affirmative relief compelling admission may be an appropriate remedy.

## Conclusion

Because Society membership functioned as an economic necessity for hospital-based practice in the county, the Court treated the Society’s denial as subject to public-policy review and ordered admission, finding the unwritten AMA-school requirement an arbitrary barrier to a fully licensed physician’s practice.


Falcone v. Middlesex Cnty. Med. Soc’y, 34 N.J. 582, 170 A.2d 791 (N.J. 1961)