Stephen Meehan v. Peter Antonellis, Dmd(075265) , 226 N.J. 216 ( 2016 )


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  •                                                       SYLLABUS
    (This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the
    convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the
    interest of brevity, portions of any opinion may not have been summarized.)
    Stephen Meehan v. Peter Antonellis, DMD (075265) (A-45-14)
    Argued March 15, 2016 – Decided August 9, 2016
    CUFF, P.J.A.D. (temporarily assigned), writing for a unanimous Court.
    In this appeal involving the Affidavit of Merit statute (AOM statute), N.J.S.A. 2A:53A-26 to -29, the Court
    determines whether an affiant submitting an affidavit of merit must have credentials equivalent to those of the
    defendant, either pursuant to the like-qualified standard of the Patients First Act, N.J.S.A. 2A:53A-41 (section 41),
    or under the credentials standards outlined in N.J.S.A. 2A:53A-27 (section 27) of the AOM statute. The Court also
    determines the sufficiency of the affidavit of merit that plaintiff submitted in support of his action against defendant
    for dental malpractice.
    Plaintiff consulted defendant, an orthodontist, seeking treatment for sleep apnea. Defendant fitted plaintiff
    with a dental appliance intended to reduce plaintiff’s symptoms. After wearing the device while sleeping, plaintiff
    noticed that his teeth had shifted. A subsequent sleep study revealed that plaintiff’s symptoms worsened during the
    time that he used the appliance. Defendant attempted to remedy plaintiff’s condition with a new appliance, without
    success. Plaintiff filed an action for dental malpractice against defendant, alleging that defendant’s treatment
    created large gaps between his teeth and worsened his sleep apnea condition. Defendant’s answer to the complaint
    did not identify the field in which he specialized and whether his treatment of plaintiff involved that specialty, as
    required by Rule 4:5-3.
    Plaintiff filed a timely affidavit of merit from a dentist who specializes in prosthodontics and has over
    twenty years of experience in the treatment of sleep apnea. He opined that defendant’s failure to inform plaintiff of
    the risks associated with use of the dental device fell outside the standards of care for oral appliance therapy.
    Defendant filed a motion to dismiss plaintiff’s complaint with prejudice, asserting that plaintiff was required to
    submit an affidavit of merit from a like-qualified dentist, which, in this case, was an orthodontist. The trial court
    granted defendant’s motion and dismissed plaintiff’s complaint with prejudice. The court held that section 27 of the
    AOM statute required that the affidavit of merit be submitted by a like-qualified professional who practices in the
    same specialty or subspecialty as the defendant, and therefore required plaintiff to submit an affidavit of merit from
    an orthodontist. The court denied plaintiff’s motion for reconsideration, finding that the affiant and defendant were
    not equivalently qualified because the affiant specialized in different areas of practice.
    The Appellate Division affirmed the orders dismissing plaintiff’s complaint with prejudice and denying
    reconsideration. The appellate panel recognized the distinction between medical malpractice and dental malpractice
    actions, but found that the credentialing requirements for affiants who provide an affidavit in a medical malpractice
    action under section 41 of the Patients First Act also apply to section 27 of the AOM statute. Applying that
    standard, the panel concluded that plaintiff’s affiant lacked the requisite statutory qualifications to issue an affidavit
    of merit against the defendant.
    This Court granted plaintiff’s petition for certification. 
    221 N.J. 218
    (2015).
    HELD: The enhanced requirements of section 41 of the Patients First Act which govern the qualifications of
    persons permitted to submit an affidavit of merit, or provide expert testimony, in a medical malpractice action, apply
    only in medical malpractice actions. In all other actions against a licensed professional, section 27 of the AOM
    statute prescribes the qualifications of the person who may submit an affidavit of merit against a licensed
    professional. The affidavit of merit that plaintiff submitted in this action, from a licensed dentist with experience in
    the treatment of sleep apnea, satisfies section 27. The trial court therefore improperly dismissed the complaint.
    1. The AOM statute is intended to eliminate frivolous claims against licensed professionals early in the litigation
    1
    process, and to permit meritorious claims to proceed efficiently. Under section 27 of the statute, a plaintiff alleging
    that certain designated professionals negligently performed professional services is required to provide an affidavit
    from an expert attesting to the merits of the claim. The submission of an affidavit of merit is considered an element
    of the claim, and the failure to submit an appropriate affidavit of merit ordinarily requires dismissal of the complaint
    with prejudice. However, a complaint will not be dismissed if the plaintiff has substantially complied with the
    affidavit of merit obligations. Additionally, if the plaintiff can demonstrate extraordinary circumstances that
    prevented compliance, the complaint will be dismissed without prejudice. An accelerated case management
    conference, as required by Ferreira v. Rancocas Orthopedic Assocs. 
    178 N.J. 144
    (2003), is intended to identify and
    address, early in the litigation, any issues concerning the affidavit of merit. (pp. 14-18)
    2. Section 27 of the AOM statute was amended in 2004 to direct that medical malpractice actions comply with
    section 41 of the Patients First Act. Section 41 precludes a person from providing expert testimony or executing an
    affidavit of merit in a medical malpractice action unless the expert or affiant is a licensed physician or other health
    care professional in the United States, and meets other standards, depending on the qualifications and area of
    practice of the party against whom or on whose behalf the testimony is provided. In all negligence actions against
    designated licensed professionals, other than medical malpractice actions, the affidavit of merit is governed by the
    original provisions of section 27. (pp. 18-20)
    3. In determining whether the enhanced credential standards stated in section 41 apply to an action for dental
    malpractice, the Court examines the legislative intent of the statute. The plain language of section 41 states that the
    like-qualified standards apply only to physicians who are defendants in medical malpractice actions. This
    interpretation is also supported by and consistent with the stated purpose of the Patients First Act and its legislative
    history. The issues regarding the delivery of health care that the Legislature identified and the measures that the
    Legislature adopted to address them with the adoption of section 41 pertain only to physicians, without reference to
    any other licensed professionals. Under the plain language of sections 27 and 41, the enhanced credential
    requirements established by section 41 for those submitting affidavits of merit and expert testimony apply only to
    physicians in medical malpractice actions. (pp. 21-25)
    4. Section 27, which is applicable here, does not impose a like-qualified standard for an affiant who submits an
    affidavit of merit in a negligence action against designated professionals. The language of section 27 under
    consideration has remained unchanged since the AOM statute was adopted in 1995. Section 27 requires the affiant
    to be licensed in this or another state, and have particular expertise in the general area or specialty involved in the
    action, and addresses the manner in which that expertise may be demonstrated. There is no textual support for the
    application of the like-qualified requirement of section 41 to affiants submitting an affidavit of merit against
    designated professionals under section 27. (pp. 25-26)
    5. Based on the statute’s plain language and the manner in which it has been applied since its adoption, the Court
    concludes that section 27 requires no more than that the person submitting an affidavit of merit be licensed in this or
    another state, and have particular expertise in the general area or specialty involved in the action. The enhanced
    requirements of section 41 governing the qualifications of persons permitted to submit an affidavit of merit, or
    provide expert testimony against or in support of a physician in a medical malpractice action, apply only in medical
    malpractice actions. In this case, the affiant is a licensed dentist who has particular expertise in the diagnosis and
    treatment of sleep apnea, the general area involved in the professional negligence action that plaintiff commenced.
    Measured by these standards, the affidavit of merit that plaintiff submitted satisfied the requirements of section 27.
    (pp. 28-34)
    The judgment of the Appellate Division is REVERSED, and the matter is REMANDED to the trial court
    for further proceedings.
    CHIEF JUSTICE RABNER, JUSTICES LaVECCHIA, ALBIN, FERNANDEZ-VINA and
    SOLOMON, join in JUDGE CUFF’s opinion. JUSTICE PATTERSON did not participate.
    2
    SUPREME COURT OF NEW JERSEY
    A-45 September Term 2014
    075265
    STEPHEN MEEHAN,
    Plaintiff-Appellant,
    v.
    PETER ANTONELLIS, DMD,
    Defendant-Respondent.
    Argued March 15, 2016 – Decided August 9, 2016
    On certification to the Superior Court,
    Appellate Division.
    E. Drew Britcher argued the cause for
    appellant (Britcher Leone, attorneys; Mr.
    Britcher and Jessica E. Choper, on the
    briefs).
    Kenneth M. Brown argued the cause for
    respondent (Wilson, Elser, Moskowitz,
    Edelman & Dicker, attorneys; Robert T.
    Gunning, of counsel and on the briefs).
    Abbott S. Brown argued the cause for amicus
    curiae New Jersey Association for Justice
    (Lomurro, Munson, Comer, Brown and
    Schottland, attorneys; Mr. Brown, Jonathan
    H. Lomurro, and Christina Vassiliou Harvey,
    on the brief).
    John Zen Jackson argued the cause for amicus
    curiae Medical Society of New Jersey
    (McElroy, Deutsch, Mulvaney & Carpenter,
    attorneys).
    JUDGE CUFF (temporarily assigned) delivered the opinion of
    the Court.
    1
    In this appeal, we return to the vexing and recurring issue
    of whether an affidavit of merit submitted by a plaintiff in an
    action alleging negligence by a licensed professional satisfies
    the requirements of the Affidavit of Merit statute (AOM
    statute), N.J.S.A. 2A:53A-26 to -29.    Plaintiff sought treatment
    for sleep apnea from an orthodontist.   Plaintiff used the
    appliance given to him for treatment but complained that it
    caused the dislocation of some teeth.   Contending that the
    orthodontist did not inform him that the appliance may dislocate
    teeth, plaintiff filed a complaint alleging that the treating
    orthodontist provided insufficient information to permit him to
    make an informed decision to proceed with the recommended
    treatment.
    The trial court conducted a Ferreira1 conference and
    determined that plaintiff submitted a timely affidavit of merit;
    however, the court dismissed with prejudice plaintiff’s
    complaint because plaintiff submitted the affidavit from a
    dentist who specialized in prosthodontics and the treatment of
    sleep apnea.   The court stated that plaintiff knew that the
    dentist who treated him was an orthodontist and that the statute
    required submission of an affidavit of merit from a like-
    qualified dentist.   In other words, the court determined that
    1   Ferreira v. Rancocas Orthopedic Assocs., 
    178 N.J. 144
    (2003).
    2
    plaintiff was required to submit an affidavit of merit from an
    orthodontist rather than an affidavit from a board-certified
    prosthodontist who had specialized in the treatment of sleep
    apnea for twenty years.
    Since the adoption in 2004 of the New Jersey Medical Care
    Access and Responsibility and Patients First Act (Patients First
    Act), N.J.S.A. 2A:53A-37 to -42, there has been a proliferation
    of litigation yielding disparate results on whether the enhanced
    qualification standards of the Patients First Act in medical
    malpractice actions apply to negligence actions against all
    licensed professionals.   In addition, we have repeatedly
    addressed the contours of the Ferreira conference due to
    problems with the timing of the conference, the omission of the
    conference in some instances, and the substance of such
    conferences.
    In this appeal, we hold that the like-qualified standard2
    prescribed in the Patients First Act, N.J.S.A. 2A:53A-41
    (section 41), applies only in actions for medical malpractice.
    In all other negligence actions against a licensed professional,
    the credential standards outlined in N.J.S.A. 2A:53A-27 (section
    27) apply.
    2 This standard is also referred to in case law and litigation as
    “like-credentialed,” “equivalently credentialed,” “equivalently
    qualified,” and “kind-for-kind.”
    3
    The Ferreira conference is designed to identify and
    alleviate issues regarding the affidavit of merit.      Here, the
    Ferreira conference failed to accomplish one of its primary
    functions, that is, determining whether the treatment provided
    by the professional defendant involved the defendant’s
    specialty.   Normally, we would vacate the dismissal with
    prejudice and remand to permit the plaintiff to obtain an
    affidavit of merit from a qualified professional.      That remedy
    is unnecessary here.   There is no need to prolong this already
    protracted matter because we conclude that the affidavit of
    merit submitted by plaintiff satisfies the credential
    requirements of section 27.   We therefore reverse the judgment
    of the Appellate Division and remand the matter to the trial
    court for further proceedings.
    I.
    We derive the facts from a record limited to the
    transcripts of the Ferreira conference, the motion to dismiss,
    and the motion for reconsideration, as well as the briefs and
    exhibits submitted in support of and in opposition to those
    motions.
    Plaintiff consulted defendant for treatment for sleep
    apnea.   On May 4, 2010, defendant fitted plaintiff with a dental
    appliance known as a positioner.       The device was intended to
    help reduce plaintiff’s sleep apnea symptoms.      Plaintiff asserts
    4
    that he expressed a concern that the device would cause his
    teeth to shift and that defendant “unequivocally assured” him
    that his teeth would not move.    After wearing the device while
    sleeping, plaintiff noticed that his teeth had shifted.
    Plaintiff decided to undergo a sleep study, which revealed that
    plaintiff’s condition had progressed from moderate to severe
    during the period of time that he used the appliance.     Defendant
    unsuccessfully attempted to remedy plaintiff’s condition with a
    new appliance.
    On August 29, 2012, plaintiff filed a complaint against
    defendant alleging that defendant’s treatment caused chronic
    muscle pain and headaches, created large gaps between his teeth,
    and worsened his sleep apnea condition.     Defendant filed an
    answer on October 11, 2012.     The answer did not identify the
    field in which defendant specialized and whether his treatment
    of plaintiff involved that specialty as required by Rule 4:5-3.
    A Ferreira conference was conducted on January 18, 2013.
    At the outset of the conference, the trial court did not realize
    the nature of the conference.    Defense counsel promptly informed
    the court that plaintiff had not filed an affidavit of merit and
    that the document was due in about three weeks.     Addressing
    plaintiff, who was self-represented, the trial court informed
    plaintiff that he was required to submit an affidavit of merit.
    Plaintiff stated that he was familiar with the affidavit of
    5
    merit requirement but requested the court “to explain [the
    requirement], just to make sure there is no misunderstanding[.]”
    The trial court proceeded to explain the purpose of the
    affidavit of merit, mentioned that the affidavit was not a
    substitute for expert testimony at trial about the standard of
    care, and emphasized that the failure to submit an affidavit, or
    the submission of a noncompliant affidavit, would trigger a
    motion to dismiss the complaint.       Plaintiff asked whether the
    period for calculating the due date of the affidavit ran from
    the date the answer was filed or when it was received by him.
    The trial court did not directly answer that question.       Rather,
    the court stated, “You could make that argument.”       The trial
    court also informed plaintiff that a good faith effort to obtain
    an affidavit may not satisfy the statutory requirement for
    production of an affidavit of merit.
    At the conclusion of the Ferreira conference, the trial
    court realized that the matter was a dental malpractice claim.
    The trial court informed plaintiff that the affidavit “would
    have to come from a dentist or one who practices dentistry.”
    When plaintiff advised the trial court that defendant had not
    identified any area of specialty or whether his treatment
    involved that specialty, the court initially advised plaintiff
    that the information could be obtained through discovery.       The
    following exchange occurred:
    6
    THE COURT:   I’m not sure what you mean by
    that.
    [PLAINTIFF]: He’s supposed to -- by the
    rules of the court he’s supposed to respond
    what field of medicine he’s practicing and
    with this appliance (phonetic) -- apparently,
    he’s an orthodontist, and I believe he is
    practicing outside his field of expertise.
    THE COURT: There’s -- there’s discovery,
    which can take place. But I would just -- I
    don’t want you to be distracted.      There’s
    certainly time to pronounce interrogatories
    or, if you feel necessary, take depositions.
    But if this affidavit of merit issue is
    not resolved there won’t be any discovery in
    this case. Because there won’t be any case
    for discovery to take place.
    [PLAINTIFF]:     Uh hum.
    THE COURT:     All right?
    [PLAINTIFF]:     Okay.
    THE COURT:     Okay.
    [PLAINTIFF]:     Okay.      Thank you --
    THE COURT:     Thank you.
    [PLAINTIFF]:     -- for letting me try to
    voice my --
    THE COURT:     That’s okay.      All right.
    [DEFENSE COUNSEL]:         Thank you, Judge.
    At no time did the trial court address defendant’s failure to
    provide the information required by Rule 4:5-3.          Defense counsel
    did not provide any information about whether defendant’s
    treatment of plaintiff involved the specialty of orthodontics.
    7
    Plaintiff filed a timely affidavit of merit from Dr. Mark
    Samani, a dentist who specializes in prosthodontics and has over
    twenty years of experience in the treatment of sleep apnea.         Dr.
    Samani stated that
    [j]aw movement, tooth movement and even
    tempor[o]mandibular joint pain are all know[n]
    complications associated with oral appliance
    therapy for the treatment of obstructive sleep
    apnea. These complications arising in and of
    themselves are not breach[es] of the standards
    of care. Based on my knowledge, education and
    experience in the treatment of obstructive
    sleep apnea with oral appliances, if the
    patient was not informed about these very real
    possibilities, as stated by Mr. Meehan, th[e]n
    the patient was not given the opportunity to
    make an educated decision on treatment and the
    informed consent process fell outside the
    standards of care for oral appliance therapy
    for the treatment of obstructive sleep apnea.
    Defendant filed a motion to dismiss plaintiff’s complaint
    with prejudice, asserting that plaintiff was required to submit
    an affidavit of merit from a like-qualified dentist, that is, an
    orthodontist.   During oral argument on the motion, plaintiff
    advised the trial court that he was aware that defendant was an
    orthodontist but was under the impression that defendant was not
    treating him as an orthodontist.       Plaintiff explained that he
    sought and obtained an affidavit from a dentist who specializes
    in the treatment of sleep apnea.
    The trial court granted defendant’s motion and dismissed
    plaintiff’s complaint with prejudice.      In a written statement
    8
    accompanying the order, the trial court declared that section 27
    required that the affidavit of merit be submitted by a like-
    qualified professional.   Addressing the affidavit submitted by
    plaintiff, the trial court determined that “the fact that Dr.
    Samani is an expert in sleep apnea is irrelevant in this
    malpractice claim because the statute clearly requires the
    affidavit of merit to be submitted by a person who practices in
    the same specialty or subspecialty.”       Thus, the court declared
    that plaintiff was required to submit an affidavit of merit from
    an orthodontist.   The trial court determined that plaintiff had
    not applied for a waiver pursuant to section 41, or shown
    exceptional circumstances to permit a deviation from the
    statutory requirement of a like-qualified professional, or
    satisfied the good faith requirements of Ryan v. Renny, 
    203 N.J. 37
    (2010).
    In response to plaintiff’s motion for reconsideration,
    which the trial court denied, the trial court elaborated on its
    reasoning in a written opinion.       Relying on Buck v. Henry, 
    207 N.J. 377
    , 389 (2011), the court declared that the expert
    providing the affidavit of merit “should be equivalently-
    qualified to the defendant” physician.       The court also
    determined that the affiant and defendant were not equivalently
    qualified because the affiant specialized in prosthodontics and
    defendant specialized, and rendered treatment to plaintiff, in
    9
    orthodontics.   The trial court asserted that a dismissal with
    prejudice of plaintiff’s complaint was consistent with the rule
    announced in Nicholas v. Mynster, 
    213 N.J. 463
    (2013), an
    opinion issued following entry of the order granting a
    defendant’s motion to dismiss.   The court also reasoned that it
    could not provide any relief from the strict requirements of the
    Patients First Act because plaintiff had not applied for a
    waiver.
    The Appellate Division affirmed the orders dismissing
    plaintiff’s complaint with prejudice and denying reconsideration
    in an unpublished opinion.   Relying on this Court’s
    interpretation of section 41 in Nicholas, 
    id. at 481-82,
    the
    Appellate Division applied credentialing requirements for those
    providing an affidavit of merit or expert testimony in a medical
    malpractice action to a dental malpractice action, and declared
    that “a plaintiff’s medical expert must possess the same
    specialty or subspecialty as the defendant physician.”     The
    appellate panel recognized the distinction between medical
    malpractice and dental malpractice actions but determined that
    “the Patient[s] First Act’s detailed standards for experts
    executing an [affidavit of merit] . . . are consistent with the
    limitations found in [section 27,] which . . . mandates that
    experts in other professional malpractice actions possess
    particular expertise in the specialty involved in the action.”
    10
    Applying that standard, the panel concluded that plaintiff’s
    affiant “lacked the requisite statutory qualifications to issue
    an [affidavit of merit] against defendant.”   The appellate panel
    also determined that defendant’s failure to identify his
    specialty was not fatal because the Ferreira conference record
    demonstrated that plaintiff knew that defendant was an
    orthodontist.
    The Court granted plaintiff’s petition for certification to
    address three questions: (1) whether the Appellate Division
    erred in extending the Patients First Act to dental malpractice
    actions; (2) whether the Appellate Division erred in determining
    that plaintiff’s affidavit of merit from Dr. Samani was
    insufficient because it was not from an orthodontist; and (3)
    whether, due to the alleged Ferreira conference failures,
    exceptional circumstances exist warranting reinstatement of
    plaintiff’s complaint.   Meehan v. Antonellis, 
    221 N.J. 218
    (2015).
    II.
    A.
    Plaintiff asserts that the plain language of section 41
    dictates that the enhanced or like-qualified requirements of the
    Patents First Act apply only to medical malpractice actions.
    Plaintiff acknowledges that the Appellate Division noted that
    section 41 applies only to medical malpractice actions, but
    11
    states that the panel nonetheless proceeded to apply the expert
    credential requirements governing medical malpractice actions to
    this dental malpractice action.    Plaintiff further argues that
    the affidavit of merit submitted by Dr. Samani satisfied the
    qualification requirements of section 27 because plaintiff
    received treatment for sleep apnea, Dr. Samani is a licensed
    dentist who specialized in prosthodontics, a specialty that
    treats sleep apnea, Dr. Samani has specialized in the treatment
    of sleep apnea for over twenty years, and the treatment provided
    by defendant to plaintiff did not fall solely within the field
    of orthodontics.
    In the alternative, if this Court determines that Dr.
    Samani’s affidavit of merit does not satisfy the statutory
    requirements for this dental negligence matter, plaintiff
    requests that this Court permit him additional time to present a
    conforming affidavit.   Plaintiff maintains that the Ferreira
    conference did not adequately address the issue of defendant’s
    qualifications as required by 
    Buck, supra
    , 207 N.J. at 394-95.
    B.
    Defendant argues that the Appellate Division correctly
    affirmed the dismissal with prejudice of plaintiff’s complaint
    because plaintiff failed to serve an appropriate affidavit of
    merit.   Defendant maintains that plaintiff knew defendant was an
    orthodontist, and therefore, the affiant must be an
    12
    orthodontist, that plaintiff never asserted his claim was
    limited to informed consent, and that the appellate panel did
    not extend the Patients First Act to dentists.   Defendant argues
    that the trial court said nothing at the Ferreira conference
    that would have led plaintiff to believe that he could submit an
    affidavit of merit from any licensed dentist other than an
    orthodontist.   Addressing plaintiff’s contention that
    defendant’s silence in his answer and at the conference about
    his specialty contributed to the submission of an affidavit by a
    dentist other than one specializing in orthodontics, defendant
    argues that he also “never asserted that he treated [plaintiff]
    outside of his dental practice specialty of orthodontics.”     In
    other words, defendant argues that plaintiff should have assumed
    that the treatment provided by defendant fell within the
    specialty of orthodontics unless and until he was informed to
    the contrary.
    Furthermore, defendant argues that section 27 requires
    “particular expertise in the general area or specialty involved
    in the action.”   Asserting that he treated plaintiff from 2002
    to 2012 exclusively as an orthodontist, defendant maintains that
    the record does not support a conclusion that he treated
    plaintiff as a general dentist or in any way outside his
    established specialty.   Defendant acknowledges that Dr. Samani
    has devoted over twenty years to the treatment of sleep apnea
    13
    but maintains that plaintiff has not established that Dr.
    Samani’s prosthodontics specialty overlaps with defendant’s
    specialty in orthodontics.
    C.
    Amicus curiae New Jersey Association for Justice (NJAJ)
    argues that the Patients First Act unconstitutionally interferes
    with the judiciary’s power to regulate practice and procedure in
    the courts.   Amicus curiae Medical Society of New Jersey (MSNJ)
    recognizes that the issue raised by NJAJ is not within the scope
    of the order granting certification.   Nevertheless, MSNJ
    responds that the AOM statute and the Patients First Act do not
    transgress the separation of powers doctrine because the
    Patients First Act addresses substantive elements of a cause of
    action rather than the admissibility of evidence.   MSNJ also
    argues that dismissals for noncompliance with either statute
    should be without prejudice.
    III.
    The stated purpose of the AOM statute, N.J.S.A. 2A:53A-26
    to -29, is laudatory -- to weed out frivolous claims against
    licensed professionals early in the litigation process.
    Ferreira v. Rancocas Orthopedic Assocs., 
    178 N.J. 144
    , 146
    (2003).   The submission of an appropriate affidavit of merit is
    considered an element of the claim.    See Alan J. Cornblatt, P.A.
    v. Barow, 
    153 N.J. 218
    , 244 (1998) (holding that failure to
    14
    submit affidavit of merit “goes to the heart of the cause of
    action as defined by the Legislature”).    Failure to submit an
    appropriate affidavit ordinarily requires dismissal of the
    complaint with prejudice.    
    Id. at 243.
    On its face, the AOM statute did not seem to impose “overly
    burdensome obligations,” 
    Ferreira, supra
    , 178 N.J. at 146, yet
    this single piece of legislation has unleashed a veritable
    avalanche of litigation.    This Court addressed the initial
    statute, originally enacted in 1995, nine times before the
    Legislature adopted further obligations regarding medical
    malpractice actions in 2004.    
    Id. at 144;
    Palanque v. Lambert-
    Woolley, 
    168 N.J. 398
    (2001); Hubbard ex rel. Hubbard v. Reed,
    
    168 N.J. 387
    (2001); Fink v. Thompson, 
    167 N.J. 551
    (2001);
    Christie v. Jeney, 
    167 N.J. 509
    (2001); Galik v. Clara Maass
    Med. Ctr., 
    167 N.J. 341
    (2001); Burns v. Belafsky, 
    166 N.J. 466
    (2001); 
    Cornblatt, supra
    , 
    153 N.J. 218
    ; In re Petition of Hall,
    
    147 N.J. 379
    (1997).
    Consistent with the dual purposes of the statute to
    identify and eliminate unmeritorious claims against licensed
    professionals and to permit meritorious claims to proceed
    efficiently through the litigation process, 
    Hubbard, supra
    , 168
    N.J. at 395, the Court fashioned two equitable remedies “that
    temper the draconian results of an inflexible application of the
    statute,” 
    Ferreira, supra
    , 178 N.J. at 151.    Thus, a complaint
    15
    will not be dismissed if the plaintiff substantially complied
    with the affidavit of merit obligations, 
    Palanque, supra
    , 168
    N.J. at 405-06; 
    Fink, supra
    , 167 N.J. at 351-59, and a complaint
    will be dismissed without prejudice if the plaintiff can
    demonstrate extraordinary circumstances that prevented
    compliance, 
    Palanque, supra
    , 168 N.J. at 404-05.
    Still, problems persisted, turning the seemingly
    straightforward obligations of the statute into a procedural
    minefield and spawning a new subset of motion practice in
    professional liability litigation.   It was in this context that
    the Court declared in Ferreira that an accelerated case
    management conference should be conducted within ninety days of
    the filing of an answer to identify and address any and all
    issues concerning the affidavit of merit served or not served by
    the plaintiff.   The Court directed that,
    [a]t the conference, the court will address
    all discovery issues, including whether an
    affidavit of merit has been served on
    defendant. If an affidavit has been served,
    defendant will be required to advise the court
    whether he has any objections to the adequacy
    of the affidavit. If there is any deficiency
    in the affidavit, plaintiff will have to the
    end of the 120-day time period to conform the
    affidavit to the statutory requirements. If
    no affidavit has been served, the court will
    remind the parties of their obligations under
    the statute and case law.
    [
    Ferreira, supra
    , 178 N.J. at 155.]
    16
    Soon thereafter, the Legislature enacted the Patients First
    Act, adding further obligations to the affidavit of merit
    requirement.   This appeal presents the fourth occasion for this
    Court to consider the issues that have arisen from the 2004
    amendments.    See 
    Nicholas, supra
    , 
    213 N.J. 463
    ; 
    Buck, supra
    , 
    207 N.J. 377
    ; 
    Ryan, supra
    , 
    203 N.J. 37
    .
    In this appeal, we address two issues.     First, we address
    whether the like-credential requirements of section 41 apply in
    professional negligence actions other than medical malpractice
    actions.   Second, we address whether the Ferreira conference
    conducted in this matter adequately addressed the sufficiency of
    the affidavit of merit required for plaintiff’s dental
    malpractice action to proceed.    We review these legal issues de
    novo.   See Mortgage Grader, Inc. v. Ward & Olivio, L.L.P., ___
    N.J. ___, ___ (2016) (slip op. at 10) (“An appellate court
    interprets both statutes and court rules de novo.”).     We
    commence our discussion with the interpretive issue presented by
    the affidavit of merit submitted by plaintiff in this action.
    A.
    The starting point for our inquiry is the text of two
    statutes -- N.J.S.A. 2A:53A-27 and -41.    Section 27 is the
    central element of legislation adopted in 1995 and commonly
    referred to as the AOM statute.    L. 1995, c. 139.   In general
    terms, the Legislature established a procedure that required a
    17
    person alleging that certain designated professionals
    negligently performed professional services to produce an
    affidavit from an expert attesting to the merits of the claim.
    Dentists were and continue to be among the licensed persons
    covered by the AOM statute.   N.J.S.A. 2A:53A-26(d).
    Section 27, in its original form, provided as follows:
    In any action for damages for personal
    injuries, wrongful death or property damage
    resulting from an alleged act of malpractice
    or negligence by a licensed person in his
    profession or occupation, the plaintiff shall
    . . . provide each defendant with an affidavit
    of an appropriate licensed person that there
    exists a reasonable probability that the care,
    skill or knowledge exercised or exhibited in
    the treatment, practice or work that is the
    subject of the complaint, fell outside
    acceptable professional . . . standards or
    treatment practices. . . .         The person
    executing the affidavit shall be licensed in
    this or any other state; have particular
    expertise in the general area or specialty
    involved in the action, as evidenced by board
    certification or by devotion of the person’s
    practice substantially to the general area or
    specialty involved in the action for a period
    of five years[.]
    [L. 1995, c. 139, § 2 (codified at N.J.S.A.
    2A:53A-27).]
    The section also requires that the affiant have no financial
    interest in the outcome of the matter.   
    Ibid. As part of
    certain 2004 tort reform measures regarding
    medical malpractice actions, language was added to section 27,
    L. 2004, c. 17, § 8, expressly directing that medical
    18
    malpractice actions be treated in accordance with the
    requirements of section 41 of the Patients First Act.     As
    amended, the relevant portion of section 27 now states:
    In the case of an action for medical
    malpractice,   the   person    executing   the
    affidavit shall meet the requirements of a
    person who provides expert testimony or
    executes an affidavit as set forth in [section
    41].
    [N.J.S.A. 2A:53A-27.]
    The standards in the original statute continue to apply “[i]n
    all other cases.”   
    Ibid. In other words,
    in all negligence
    actions against designated licensed professionals, other than
    medical malpractice actions, the affidavit of merit is governed
    by the original provisions of section 27.
    Section 41 “establishes qualifications for expert witnesses
    in medical malpractice actions” and “provides that an expert
    must have the same type of practice and possess the same
    credentials, as applicable, as the defendant health care
    provider, unless waived by the court.”    Assembly Appropriations
    Comm., Statement to Assembly No. 50, at 2 (2004).
    Section 41 precludes a person from providing expert
    testimony or executing an affidavit of merit in a medical
    malpractice action unless the expert or affiant is a licensed
    physician or other health care professional in the United States
    and meets other standards, depending on the qualifications and
    19
    area of practice of the party against whom or on whose behalf
    the testimony is provided.   See N.J.S.A. 2A:53A-41a.       The
    equivalency or kind-for-kind credential requirement may be
    waived if the moving party demonstrates that a good faith effort
    failed to yield a qualifying expert in the specialty or
    subspecialty, and the trial court determines that the proposed
    expert or affiant has sufficient training, experience, and
    knowledge to provide an opinion.     N.J.S.A. 2A:53A-41c.    The
    training, education, and experience must be derived from “active
    involvement in, or full-time teaching of, medicine in the
    appropriate area of practice or a related field of medicine.”
    Ibid.
    In 
    Buck, supra
    , we characterized sections 41a and b of the
    Patients First Act “as setting forth three distinct categories
    embodying this “kind-for-kind” rule:
    (1) those who are specialists in a field
    recognized by the American Board of Medical
    Specialties (ABMS) but who are not board
    certified in that specialty;
    (2) those who are specialists in a         field
    recognized by the ABMS and who are         board
    certified in that specialty; and
    (3) those who are “general practitioners.”
    [207 N.J. at 389.]
    See also 
    Nicholas, supra
    , 
    213 N.J. 483
    .
    B.
    20
    To resolve the interpretive issue before the Court, that
    is, whether a person submitting an affidavit of merit in a
    dental malpractice action must comply with the enhanced
    credential standards set forth in section 41, we must examine
    the canons of statutory interpretation that apply to this case.
    When the interpretation of a statute is at issue, “[t]he
    objective of that task ‘is to discern and effectuate the intent
    of the Legislature.’”   Shelton v. Restaurant.com, Inc., 
    214 N.J. 419
    , 428-29 (2013) (quoting Murray v. Plainfield Rescue Squad,
    
    210 N.J. 581
    , 592 (2012)).
    We commence our examination of the text of the AOM statute
    and the Patients First Act with section 27.     See DiProspero v.
    Penn, 
    183 N.J. 477
    , 492 (2005) (stating that best indicator of
    Legislature’s intent is statutory language (citing Frugis v.
    Bracigliano, 
    177 N.J. 250
    , 280 (2003)).      In 2004, the AOM
    statute was amended to add a sentence to section 27.      That
    sentence provides that “[i]n the case of an action for medical
    malpractice, the person executing the affidavit shall meet the
    requirements of a person who provides expert testimony or
    executes an affidavit as set forth in [section 41].”      L. 2004,
    c. 17, § 8.   The 2004 amendment then adds the phrase “in all
    other cases” to the existing sentence that describes the
    credentials for those submitting an affidavit of merit in
    professional negligence actions.     
    Ibid. 21 Section 41
    addresses the qualifications for those providing
    expert testimony or an affidavit of merit “in an action alleging
    medical malpractice.”   N.J.S.A. 2A:53A-41.    The expert or
    affiant must be a licensed physician, ibid., and must meet
    additional criteria depending on the qualifications and area of
    practice of the physician against whom or on whose behalf an
    opinion is offered, N.J.S.A. 2A:53A-41a and b.
    The plain language of section 41 states that the like-
    qualified standards apply only to physicians.     And it does so
    repeatedly.   For example, N.J.S.A. 2A:53A-41a governs parties to
    a medical malpractice action who are specialists or
    subspecialists recognized by the American Board of Medical
    Specialties or the American Osteopathic Association.     Those
    organizations recognize and establish the criteria for board
    certification only for physicians.     The proposed expert or
    affiant must have specialized in the same specialty or
    subspecialty recognized by those organizations.     Only a
    physician may satisfy that standard.     Further, if the physician
    party is board certified in a specialty or subspecialty and the
    care and treatment provided by the physician involved that
    specialty or subspecialty, the expert or affiant must be a
    physician with credentials from a hospital to treat patients for
    the medical condition or perform the procedure that is the
    subject of the claim, or a physician who possesses board
    22
    certification in the same specialty or subspecialty as the
    physician and has devoted a majority of his or her professional
    practice to that specialty or subspecialty through active
    clinical practice or the instruction of students or both.
    N.J.S.A. 2A:53A-41a.
    Similarly, only a physician falls within the bounds of
    N.J.S.A. 2A:53A-41b.   That subsection addresses general
    practitioners and limits the expert or affiant to a physician
    (1) actively engaged in “clinical practice as a general
    practitioner” or active in clinical practice involving the
    medical condition or procedure that is the basis of the claim,
    or (2) who instructs students at an accredited medical school,
    health professional school, or residency or research program or
    both.   
    Ibid. Interpreting section 41’s
    like-qualified credential
    requirements as applying only to physicians who are defendants
    in medical malpractice actions is also supported by and
    consistent with the stated purpose of the Patients First Act and
    its legislative history.   See Wilson ex rel. Manzano v. City of
    Jersey City, 
    209 N.J. 558
    , 572 (2012) (“When the statutory
    language is sufficiently ambiguous that it may be susceptible to
    more than one plausible interpretation, we may turn to such
    extrinsic guides as legislative history, including sponsor
    statements and committee reports.” (citing Burns, supra, 
    166 23 N.J. at 473
    )).   In enacting the Patients First Act, the
    Legislature made several findings and declarations regarding the
    state of health care in this State and identified the retirement
    or relocation of physicians as a problem hampering the delivery
    of high-quality health care in New Jersey.     See N.J.S.A. 2A:53A-
    38.   Furthermore, the Legislature determined that a confluence
    of factors, including a dramatic escalation of medical
    malpractice liability insurance premiums, was related to the
    State’s tort liability system and contributing to the State’s
    shortage of qualified physicians.     
    Ibid. The Legislature concluded
    that certain reforms were necessary to counteract the
    identified problems.   
    Ibid. One of those
    reforms is embodied in
    the enhanced standards contained in section 41 governing a
    person who submits an affidavit of merit or an expert opinion in
    favor of or against a physician in a medical malpractice action.
    The problems identified by the Legislature and the measures
    adopted to address those problems pertain only to physicians.
    There is no mention made of any other licensed professional in
    section 41.
    In sum, we conclude that the plain language of sections 27
    and 41 lead to the inexorable conclusion that the enhanced
    credential requirements established under section 41 for those
    submitting affidavits of merit and expert testimony apply only
    to physicians in medical malpractice actions.     See Lozano v.
    24
    Frank DeLuca Constr., 
    178 N.J. 513
    , 522 (2004) (instructing that
    court applies statute as written when legislative intent is
    clear (citing In re Passaic Cty. Utils. Auth., 
    164 N.J. 270
    , 299
    (2000))).   This determination does not conclude our inquiry,
    however, for we must determine whether section 27 itself imposes
    a similar like-qualified standard for affiants and experts in
    all other negligence actions against designated professionals,
    including dentists.
    C.
    Plaintiff argues that section 27 does not impose a like-
    qualified standard for the person selected to submit an
    affidavit of merit in this dental malpractice action.     Rather,
    plaintiff contends that the affiant must be licensed to practice
    dentistry in this state and have particular expertise in the
    general area or specialty involved, which may be evidenced by
    the affiant substantially devoting his practice to the area or
    specialty involved.
    Defendant disagrees.   Defendant argues that only an
    affidavit from a similarly credentialed dentist will satisfy the
    AOM statute because he is a board-certified orthodontist and has
    substantially devoted his practice to orthodontics.
    The language under consideration from section 27 is not
    new.    Indeed, it has remained unchanged since the AOM statute
    25
    was adopted in 1995.   The only addition to section 27 is a third
    sentence directing that the standards governing the person
    submitting an affidavit of merit or expert testimony against or
    in support of a physician in a medical malpractice action shall
    be governed by section 41.
    On its face, section 27 requires a plaintiff to “provide
    each defendant with an affidavit of an appropriate licensed
    person.”   Section 27 requires the affiant to be licensed in this
    or another state and have “particular expertise in the general
    area or specialty involved in the action.”   Section 27 then
    addresses the manner in which that expertise may be
    demonstrated.   There is simply no textual support for the
    application of the like-qualified requirements of section 41 to
    those submitting an affidavit of merit in negligence actions
    against designated professionals, such as dentists.
    D.
    Relatively few opinions have directly addressed the
    sufficiency of credentials of the person submitting the
    affidavit of merit and, specifically, whether the person
    submitting an affidavit of merit must be licensed in the same
    profession or specialize in the same field as the defendant.
    Those cases that have addressed the issue have held that in
    certain circumstances the affiant should be a similarly licensed
    professional but have not addressed whether the affiant must
    26
    share the defendant’s specialty.    Hill Int’l v. Bd. of Educ.,
    
    438 N.J. Super. 562
    , 570 (App. Div. 2014) (holding licensed
    engineer not appropriately licensed person to provide affidavit
    of merit against architect), appeal dismissed, 
    224 N.J. 523
    (2016); Medeiros v. O’Donnell & Naccarato, Inc., 
    347 N.J. Super. 536
    , 542 (App. Div. 2002) (holding affidavit of merit submitted
    by licensed engineer and architect against defendant engineering
    firm sufficient); Borough of Berlin v. Remington & Vernick
    Eng’rs, 
    337 N.J. Super. 590
    , 597-98 (App. Div.) (holding
    licensed professional hydrogeologist appropriately licensed
    person to submit affidavit of merit against defendant
    engineering firm which allegedly negligently sited and
    constructed two wells), certif. denied, 
    168 N.J. 294
    (2001).
    Hill International and Berlin emphasize that the like-
    licensed requirement for the professional submitting the
    affidavit of merit rests on the assumption that the negligent
    services provided by the defendant professional were within his
    or her profession or occupation.    Hill 
    Int’l, supra
    , 438 N.J.
    Super. at 589; 
    Berlin, supra
    , 337 N.J. Super. at 596-98; see
    also Murphy v. New Road Constr., 
    378 N.J. Super. 238
    , 242-43
    (App. Div.) (holding that affidavit of merit not required if
    defendant’s conduct does not implicate standards of defendant’s
    profession), certif. denied, 
    185 N.J. 391
    (2005).     In 
    Berlin, supra
    , the hydrogeologist affiant was considered an
    27
    appropriately licensed person because the complaint focused
    solely on the alleged negligence of the engineering firm in
    failing to adhere to recognized hydrogeologic guidelines, and
    the negligent siting of two wells by its hydrogeologist
    
    employee. 337 N.J. Super. at 596
    .    In Hill 
    International, supra
    , the appellate panel held that, if the plaintiff’s claim
    implicated the standards of care governing an architect, the
    plaintiff’s affidavit of merit was required to be from an
    
    architect. 438 N.J. Super. at 594
    .3
    E.
    Based on the plain language of section 27 and the manner in
    which it has been applied since its adoption, we conclude that
    section 27 requires no more than that the person submitting an
    affidavit of merit be licensed in this state or another and have
    “particular expertise in the general area or specialty involved
    3 A pre-Patients First Act case, Wacht v. Farooqui, 312 N.J.
    Super. 184 (App. Div. 1998), addressed whether the affiant must
    share the same specialty as the defendant. The Appellate
    Division permitted an orthopedic surgeon specializing in
    shoulders and elbows to submit an affidavit of merit against a
    board-certified radiologist. Citing the statutory requirement
    that the affiant must have devoted at least five years to the
    specialty involved in the action, the Appellate Division
    determined that an orthopedic surgeon specializing in shoulders
    possessed the particular expertise required to execute an
    affidavit of merit. 
    Id. at 187-88.
    The panel also referenced
    the “overlap” of orthopedics and diagnostic radiology to support
    its conclusion that the orthopedic surgeon possessed the
    appropriate expertise to submit an affidavit of merit. 
    Id. at 188.
    28
    in the action.”   N.J.S.A. 2A:53A-27.      Such particular expertise
    is “evidenced by board certification or by devotion of the
    person’s practice substantially to the general area or specialty
    involved in the action for a period of at least five years.”
    
    Ibid. (emphasis supplied). Notably,
    section 27 is bereft of the
    rigid categories established in section 41 for those who are
    general practitioners, board-certified specialists, or non-
    board-certified specialists.    See N.J.S.A. 2A:53A-41a and b.
    Section 27 also employs the term “or” throughout its
    recitation of the expertise required for an affiant.       In
    interpreting a statute, we must give meaning to every word.
    
    Shelton, supra
    , 214 N.J. at 441.       The word “or” is a disjunctive
    term that permits a person to satisfy statutory conditions by
    meeting one, rather than all, of the identified conditions.        In
    re Adoption of Children by G.P.B., 
    161 N.J. 396
    , 406 (1999).       In
    other words, a person may submit an affidavit of merit if the
    affiant has particular expertise in the general area involved in
    the action or in the specialty involved in the action.       N.J.S.A.
    2A:53A-27.   Such particular expertise may be evidenced by board
    certification or by devotion of his practice substantially to
    the general area or specialty involved in the action for at
    least five years.   
    Ibid. In most instances,
    we anticipate that the affiant and the
    professional-defendant will be similarly licensed.      However,
    29
    there may be circumstances when the alleged departure from the
    professional standard of care is within the particular expertise
    of two licensed professions.   In such cases, in assessing the
    sufficiency of the affidavit of merit, a court must focus, as in
    Berlin, on the specific allegations of professional negligence.
    
    Berlin, supra
    , 337 N.J. Super. at 597-98; cf. Garden Howe Urban
    Renewal Assocs. v. HACBM Architects Eng’rs Planners, L.L.C., 
    439 N.J. Super. 446
    , 458-59 (App. Div. 2015) (holding that licensed
    engineer could be qualified to render expert opinion against
    architect regarding compliance with construction codes because
    both types of professionals are responsible for knowledge of and
    compliance with appropriate codes).4
    F.
    Measured by those standards, the affidavit of merit
    submitted by plaintiff satisfied the requirements of section 27.
    Dr. Samani is a licensed dentist.    He also has particular
    expertise in the diagnosis and treatment of sleep apnea -- the
    general area that is the subject of this action -- having
    devoted a significant portion of his practice to the diagnosis
    and treatment of sleep apnea for over twenty years.
    4 We therefore hesitate to endorse the broad statement expressed
    in Hill 
    International, supra
    , 438 N.J. Super. at 587, that
    “[t]he professional has a right to expect that those standards
    of care by which his or her conduct will be measured will be
    defined by the same profession in which he or she holds a
    license, and not by some other profession.”
    30
    In reaching that determination, we must acknowledge that
    the treatment of sleep apnea is not exclusive to a single dental
    specialty or subspecialty.   A variety of professionals can treat
    sleep apnea, including various types of dentists and physicians.
    See Mayo Clinic Staff: Sleep Apnea Treatments and Drugs, Mayo
    Clinic, http://www.mayoclinic.org/diseases-conditions/sleep-
    apnea/basics/treatment/con-20020286 (last visited July 15,
    2016).   In particular, sleep apnea can be treated by both
    orthodontists and prosthodontists, cf. ibid., which are two of
    the nine dental specialties recognized by the American Dental
    Association, see American Dental Association, Specialty
    Definitions, http://www.ada.org/en/education-careers/careers-in-
    dentistry/dental-specialties/specialty-definitions (last visited
    July 15, 2016).   An orthodontist is a “uniquely qualified
    specialist[] who diagnose[s], prevent[s] and treat[s] dental and
    facial irregularities to correctly align teeth and jaws.”
    American Association of Orthodontists, Who We Are, https://
    www.aaoinfo.org/about/what-we-do (last visited July 15, 2016).
    “A prosthodontist is a dentist who specializes in the esthetic
    restoration and replacement of teeth” and is a “master[] of
    complete oral rehabilitation” whose expertise may be employed to
    treat wide-ranging conditions including jaw joint disorders,
    traumatic injuries to the mouth’s structures, snoring, and sleep
    disorders.   Pacific Coast Society for Prosthodontics,    What is
    31
    Prosthodontics?, http://www.pcsp.org/whatisprostho.html (last
    visited July 15, 2016).    A prosthodontist, therefore, is capable
    of having the “particular expertise” necessary to prepare an
    affidavit of merit in support of a claim regarding negligent
    dental treatment for sleep apnea.     Plaintiff’s affiant has
    demonstrated the requisite particular expertise to further the
    purpose of identifying meritorious professional negligence
    claims.
    Having concluded that the affidavit of merit submitted by
    plaintiff is sufficient, we need not resort to the equitable
    remedies of substantial compliance and good faith effort that
    permit relaxation of the affidavit of merit requirements.       The
    statute imposes no more than a licensure requirement and
    particular expertise in the general area or specialty involved
    in the action.   Dr. Samani satisfies those requirements.       He
    does not have to share the same specialty or subspecialty as
    defendant.   Section 27 imposes only licensure and particular
    expertise standards for affiants; it does not -- either on its
    face or as applied since its enactment -- impose a like-
    credential standard akin to that of section 41.
    We also have no need to remand this matter to the trial
    court for an appropriate case management conference and review
    of the sufficiency of Dr. Samani’s affidavit because the
    affidavit is sufficient.    Cf. 
    Buck, supra
    , 207 N.J. at 395.
    32
    This appeal, however, illustrates that a timely and effective
    Ferreira conference continues to be a critical component of
    fulfilling the purpose of the AOM statute.
    An effective Ferreira conference would probably have
    prevented this appeal.   The trial court pointedly declined to
    resolve the issues presented by plaintiff.   The court stated
    that it could not give advice to plaintiff and failed to elicit
    any statement or representation from defense counsel as to
    whether defendant’s treatment of plaintiff was within his
    specialty of orthodontics, but informed plaintiff that he was
    required to submit an affidavit of merit from a dentist.     In
    sum, the Ferreira conference failed to achieve its purpose of
    identifying and resolving any affidavit of merit problems before
    imposing the ultimate sanction of a dismissal with prejudice.
    IV.
    In conclusion, we hold that the enhanced requirements of
    section 41 governing the qualifications of persons permitted to
    submit an affidavit of merit, or to provide expert testimony
    against or in support of a physician, in a medical malpractice
    action apply only in medical malpractice actions.   In all other
    actions against a licensed professional, including a dentist,
    section 27 prescribes the qualifications of the person who may
    submit an affidavit of merit against a licensed professional who
    is alleged to have acted negligently.   The affiant must hold an
    33
    appropriate license and must demonstrate particular expertise in
    the general area or specialty involved in the action, but he or
    she is not required to possess credentials equivalent to those
    of the licensed professional defendant.   Neither the plain
    language nor the purpose and history of the AOM statute or
    Patients First Act support importation of the like-credential
    standard governing physicians in medical malpractice actions to
    professional negligence actions governed by section 27.
    We also hold that the affidavit of merit submitted by
    plaintiff satisfies section 27.    The affiant is a licensed
    dentist who has particular expertise in the diagnosis and
    treatment of sleep apnea -- the general area involved in the
    professional negligence action filed by plaintiff.
    This appeal also illustrates the need for a timely and
    effective Ferreira conference in all professional negligence
    actions.   The conference is designed to identify and resolve
    issues regarding the affidavit of merit that has been served or
    is to be served.   To that end, all participants must be prepared
    to identify at the conference the general area or specialty
    involved in the action and whether the defendant was providing
    professional services within that profession or specialty.      We
    request that the Civil Practice Committee consider whether Rule
    4:5-3 should be amended to embrace all professional negligence
    actions subject to the AOM statute.
    34
    V.
    The judgment of the Appellate Division is reversed.
    CHIEF JUSTICE RABNER, JUSTICES LaVECCHIA, ALBIN, FERNANDEZ-
    VINA and SOLOMON, join in JUDGE CUFF’s opinion. JUSTICE
    PATTERSON did not participate.
    35