Mediation and medical malpractice: problems with definition and implementation.

An important aspect of the perceived problem with medical malpractice litigation is the manner in which malpractice claims are resolved.' Following the first medical malpractice crisis in the mid-1970s and the more recent difficulties with insurance costs and availability, the majority of states enacted legislation affecting the procedures used to resolve malpractice claims. 2 Procedural reforms have been motivated by a variety of concerns, including: (1) perceptions of an increasing number of medical malpractice claims filed; (2) fear that a large number of small claims are never filed because of the high transaction costs associated with litigation; (3) the unpredictability of litigated outcomes; (4) the perceived inconsistency of jury damage awards; and (5) the potential impact of the litigation system on the availability of malpractice insurance and the delivery of medical care. The procedural changes vary considerably. Some reforms were intended to have substantive effects; 3 other