Improving relations between attorneys and physicians.

DURING THE PAST 30 YEARS, THERE HAVE BEEN 3 SEPArate medical liability crises. In the first 2 crises, which occurred in the 1970s and the 1980s, either physicians experienced increasingly unaffordable insurance premiums or many specialists were unable to purchase insurance at any price. The current crisis has elements of both, especially for high-risk specialties. Cumulatively, the recurrent crises have exposed the rawness of physician antipathy toward attorneys and the legal system. That antipathy appears to be deeper and more pervasive than ever before, making it hard to imagine that relations between attorneys and physicians can get much worse. Forexample,accordingtoanAssociatedPressreport,aSouth Carolina surgeon ceased treating a patient when he found out her husband was a trial lawyer. In New Hampshire, a neurosurgeontoldtheheadof thestate’s trial lawyers thathewould not treat him for nonemergencies. A plastic surgeon in Mississippi refused to treat the daughter of a state lawmaker because of the father’s stand on malpractice suits. Several physicians had gone so far as to post names of plaintiffs, their attorneys, and expert witnesses on a Web site (since removed) designed to identify patients who initiated medical liability litigation. The American Medical Association debated a resolution that would ethically permit physicians to refuse treatment for attorneys involved in medical malpractice cases. Although the motion was soundly defeated, it reveals the extent of some physicians’ pent-up frustrations and depth of anger toward attorneys and the liability system. A New Yorker cartoon titled “Hippocrates off the Record” captures the animosity, with the caption reading, “First, treat no lawyers.” These developments raise the specter of a profound breach between attorneys and physicians. Therefore, it is important to consider ways to repair the relationship. Arguably, much of the antipathy stems from entrenched mistrust over medical liability rather than fundamental and irredeemable differences. The mutual distrust is not over differences in core values but over different approaches for resolving the inevitable conflicts that arise. As elemental as the liability debate may be, it is only one aspect of a widening set of interactions between law and medicine. To avoid any further ruptures, a renewed physician-attorney dialogue that emphasizes shared values and concerns for patient safety is desirable.