## Facts

- Dr. Paul A. Greisman was an osteopathic physician with an unrestricted New Jersey license to practice medicine and surgery and similar licensure in other states.
- He established a general practice in the Vineland–Newfield area, where Newcomb Hospital was the only nearby hospital.
- Newcomb Hospital was a private, nonprofit, tax-exempt community hospital supported in substantial part by governmental funding and charitable community contributions.
- The hospital maintained a “courtesy staff” that allowed local physicians to admit and treat their own patients, but its bylaws limited eligibility to graduates of American Medical Association (AMA)-approved schools and members of the local allopathic medical society.
- Because osteopathic schools were not AMA-approved, the hospital and local medical society refused to consider Greisman’s application based solely on the bylaw.
- Greisman could visit hospitalized patients only as a “visitor,” without authority to write orders, access charts for treatment decisions, or prescribe hospital treatments.
- Greisman sued, alleging the bylaw was arbitrary and unreasonable as applied to a fully licensed physician.
- The trial court invalidated the bylaw as applied to Greisman and ordered the hospital to consider his application without regard to the AMA-approval requirement; defendants appealed.

## Issues

1. Whether a nonprofit community hospital with significant public support may treat staff-privilege decisions as purely private matters immune from judicial review.
2. Whether a bylaw requiring graduation from an AMA-approved medical school is arbitrary and invalid as applied to a fully licensed osteopathic physician seeking staff privileges.

## Decision

- The New Jersey Supreme Court affirmed the trial court’s judgment.
- The court held that the hospital’s community, charitable, and publicly supported character subjected its staff-privilege decisions to judicial scrutiny for arbitrariness and discrimination.
- The court held the AMA-approval graduation requirement invalid and unenforceable as applied to Greisman because it operated as a categorical exclusion of otherwise qualified, fully licensed osteopathic physicians.
- The hospital was required to consider Greisman’s application on its merits without applying the invalid bylaw requirement.

## Legal Principles

- A nonprofit community hospital that serves the general public and receives substantial public and charitable support is “affected with a public interest” and may not exercise staff-selection discretion on arbitrary, capricious, unreasonable, or discriminatory grounds.
- Courts may review hospital bylaws and staff-privilege decisions to ensure criteria bear a rational relationship to legitimate patient-care and institutional objectives.
- A blanket educational criterion that effectively excludes a class of fully licensed physicians, where exclusion reflects professional hostility rather than individualized competence, may be invalid as contrary to public policy.
- Hospital policies may not defeat the state’s licensing determination that a physician is qualified to practice medicine and surgery through categorical exclusions unrelated to demonstrated competence.

## Conclusion

The court required a publicly supported community hospital to evaluate a fully licensed osteopathic physician’s staff application on non-discriminatory, medically relevant grounds, holding that an AMA-approved-school bylaw that functioned as a categorical bar was arbitrary and unenforceable as applied.


Greisman v. Newcomb Hosp., 192 A.2d 817 (N.J. 1963)