Reforming the medical professional liability insurance system.

All rights reserved. Individuals may photocopy all or parts of Position Papers for educational, not-for-profit uses. These papers may not be reproduced for commercial, for-profit use in any form, by any means (electronic , mechanical, xerographic, or other) or held in any information storage or retrieval system without the written permission of the publisher. Executive Summary The American College of Physicians, representing over 115,000 internal medicine physicians and medical students, including 20,000 residents and fellows, is very much concerned about the growing crisis in the availability of medical professional liability insurance. As the largest medical specialty society and the second-largest medical society in the United States, the College is particularly concerned about rising malpractice insurance premiums and the effect on patient access to care. The existing professional liability insurance system is in desperate need of repair. While the U.S. medical malpractice system is designed to compensate and deter medically induced injury, the current system does not deter physician negligence, provide timely compensation to injured patients, or resolve disputes fairly in favor of the injured party. Additionally, there is growing concern that physicians are defensively altering their professional practices by refusing to take certain high-risk patients and ordering medically unnecessary tests for their patients in order to protect themselves in the case of a lawsuit. Furthermore, studies reveal that Americans are increasingly concerned about the frequency and severity of medical liability lawsuits and agree that litigation is one of the primary factors behind rising medical costs and reduced access to care. Additionally, the arbitrariness and inefficiency of the system makes physicians feel vulnerable to a lawsuit, thereby dismantling the physi-cian–patient relationship. As a result, comprehensive changes to the medical liability system must be made. The American College of Physicians believes that every tort reform measure should be assessed according to its capacity for lowering liability insurance premiums or reducing the frequency and severity of malpractice claims without denying injured patients appropriate redress for physician negligence. To the extent that medical professional liability reforms would result in speedier and more equitable damage awards and discourage frivolous or nonmeritorious claims, they are desirable. However, to the extent that they curtail the right to seek just and appropriate redress for medically caused injury, they hamper rather than promote a fair malpractice compensation/deterrence system (1). Over the years, the College has published several papers on reform of the medical professional liability insurance system. This paper …