The requirement that independent expert medical testimony establish the proper standard of care and the defendant's failure to meet that standard imposes an almost insurmountable obstacle in many cases. The so-called conspiracy of silence has been recognized, as a matter of judicial notice, by courts in New Jersey, California, and elsewhere. The use of that phrase to describe the unavailability of medical witnesses has particularly dramatic force which impresses a court and jury. However, no apt phrase could detract from the reality of this practical problem which faces an attorney representing a client seeking damages from a physician for professional negligence.
Richard M. Markus, Conspiracy of Silence, 14 Clev.-Marshall L. Rev. 520 (1965)