There are few topics in health care that incite as much fervor as the American malpractice system. Almost every interested party—patients, physicians, and policymakers—has expressed an opinion on malpractice reform. Physicians, particularly through professional organizations, have long argued that the American malpractice system leads to a multitude of problems, such as an aversion to disclose medical errors, defensive medicine (the overuse of clinical services because of malpractice fears), and limitations on access to care, particularly care that is perceived as high risk.
Policymakers have been divided on how to improve the malpractice system, with some advocating limitations on cases and awards and others promoting increased transparency of medical errors. Historically this divide has made it difficult to achieve universal changes to the malpractice system; however, given health care's prominent status on the national policy agenda, now may be an opportune time for constructive reform.
Improvements to the American malpractice system have the potential to diminish costs, improve quality, and expand access. For example, efforts to rein in health care costs could be more effective if physicians were less inclined to practice defensive medicine. Similarly, attempts to promote high-quality, value-based medical care may be strengthened if physicians felt protected when practicing within the standard of care. But to achieve these goals and promote successful reform, several specific shortcomings of the current system must be addressed.
