As part of ongoing reforms by the New Jersey Office of the Attorney General to combat sexual abuse and misconduct in professional settings, the state Board of Medical Examiners adopted new rules to enhance patient safety during sensitive medical examinations. The new rules at N.J.A.C. 13:35–6.23 require, among other things, that observers (formerly referred to as chaperones) complete, as of April 18, 2026, an approved training program. New Jersey licensees must timely satisfy the requirements of the new rules, or risk discipline against their license for non-compliance.
Patients’ Rights:
- A licensee or patient has the right to have an observer present during breast, pelvic, genitalia, and rectal examinations. The patient has a right to decline care if the licensee fails to provide an observer acceptable to the patient, or if an observer acceptable to the patient is not available.
- A licensee shall not be obligated to proceed with an examination for which the licensee or the patient wishes to have an observer present, or with any care or treatment for which the examination is necessary, if the licensee is unable to provide an observer acceptable to the patient, or if the patient declines the licensee’s request to have an observer present.
- If care is not provided to a patient because an acceptable observer is not available, the licensee shall, consistent with the principles of informed consent and in an unbiased manner, discuss with the patient the risks of not receiving further care at that time and provide an appropriate referral to another practitioner, if available.
Communication of the Requirements to Patients:
- In every location where the licensee provides professional services other than a healthcare facility licensed by the New Jersey Department of Health, a licensee shall provide notice to a patient, or any other person who is to be examined, of the right to have an observer present during breast, pelvic, genitalia, and rectal examinations.
- The notice shall be provided in written form to the patient and shall be conspicuously posted in a manner in which patients are made aware of the right to request an observer and to decline care if the licensee fails to provide an observer, or if an observer acceptable to the patient is not available.
- Before proceeding with a breast, pelvic, genitalia, or rectal examination, the licensee shall confirm that the patient has read and understood the notice.
- The licensee shall not proceed with the examination unless the patient has signed the written notice provided to the patient. The licensee shall keep the signed written notice in the patient’s file and provide a copy to the patient upon request. The licensee shall document the identity of the observer in the patient’s medical record.
- A licensee is not required to provide written notice to the patient or obtain the patient’s signature on the written notice in the following circumstances:
- There is substantial risk that the delay caused by providing written notice would result in significant and imminent harm, such as during a medical emergency;
- The licensee who will be conducting the examination has provided the patient with written notice and obtained the patient’s signature on the notice in the last 12 months; or
- An acceptable observer is already present in the normal course of the examination, and the licensee documents the presence of such observer in the patient’s medical record.
- In circumstances where the posting or the provision of the written notice to the patient would not convey the right to have an observer present, and to decline care if the licensee fails to provide an observer or if an observer acceptable to the patient is not available, the licensee shall use another means to ensure that the patient understands the right to have an observer present.
- Upon request, the required notice shall be made available to the patient in English, Spanish, and any of 10 or more of the most common non-English languages spoken by individuals with limited English proficiency in this State, based upon United States Census Bureau American Community Survey data, as determined by the Director.
- This determination shall be based on data from American Community Survey respondents who indicated that they speak English at a level of proficiency below “very well.”
- The Board shall post the notice in English, Spanish, and each of the 10 or more additional languages determined by the Director on its website.
- The Board shall notify licensees by email and by a notice posted on its website in the event of any revision to the Director’s determination of the 10 or more languages, other than English and Spanish.
Qualifications of Observers
Observers must produce:
- a certificate of completion of a CP-2 training course “or a course of comparable scope and rigor approved by the Board;” and
- a written affirmation that the individual has not been subject to discipline or to civil or criminal liability for failure to report misconduct and has not been convicted of sexual assault, criminal sexual contact, or lewdness pursuant to N.J.S.A. 2C:14-2, 2C:14-3, and 2C:14-4 that is of the first, second, third, or fourth degree, endangering the welfare of a child pursuant to N.J.S.A. 2C:24-4.a(1), attempting to lure or entice a child pursuant to section 1 at P.L. 1993, c. 291 (N.J.S.A. 2C:13-6), or equivalent offenses in another jurisdiction.
The observer may not be a friend or relative of the licensee or the patient; however, the licensee may permit a patient’s friend or relative to be present during an examination at the patient’s request.
The licensee must provide the following information to the observer in writing:
- The observer shall not leave the examination room or perform other tasks during an examination under observation, and the licensee shall not ask the observer to do so;
- The observer shall maintain a clear line of sight to the examination under observation, and the licensee shall not obstruct the observer;
- The observer shall report suspected misconduct to the Board at 609-826-7100 or bme@dca.lps.state.nj.us ; and
- The licensee shall not retaliate against the observer for reporting suspected misconduct.
A licensee shall make documentation of the training and affirmation of the licensee’s observers and the information provided by the licensee to the licensee’s observers available to the Board, upon request.
How Frier Levitt Can Help
Frier Levitt attorneys have deep experience navigating Board of Medical Examiners’ requirements and disciplinary matters. If you have questions about compliance with the new rules, require assistance responding to a Board inquiry, or need guidance implementing compliant policies and procedures, contact Frier Levitt to speak with an attorney.
