A medical malpractice tribunal experience.

Physicians in the United States have serious concerns about the exorbitant cost of medical liability insurance. The expense continues to have a major impact on physician practice patterns and access to medical services in many communities. More than 30 years ago, difficulty in obtaining adequate and affordable medical liability coverage generated new legislative initiatives in many states, including Massachusetts. These laws represented attempts to discourage potential plaintiffs from bringing frivolous malpractice claims and thus to limit the resultant professional and personal costs for the physician and expenses for the insurance companies. In Massachusetts, the legislature established a Medical Malpractice Tribunal, consisting of a single justice of the Superior Court, an attorney authorized to practice law in the Commonwealth and selected sequentially from a list compiled by the court, and a physician licensed to practice in the Commonwealth. On several occasions, I have served as the physician member of the Tribunal. This experience has provided me a first-hand look at one mechanism for addressing the malpractice insurance crisis. The scope of the Tribunal was limited to concerns regarding medical treatments and the professional conduct of physicians and medical institutions or facilities and covered any liability action in any county in the state. The standard of law for the Tribunal is to: . . . determine if the evidence presented if properly substantiated is sufficient to raise a legitimate question of liability appropriate for judicial inquiry or whether the plaintiff’s case is merely an unfortunate medical result. . . . [S]ubstantial evidence is that which a reasonable person might accept as adequate to support a conclusion.