Governors' report advises states on malpractice. (Damage Caps, Dispute Resolution).

With the help of states in the midst of a malpractice crisis, the National Governors Association has developed a list of ways that states can deal with, or try to stave off, problems of their own.

The governors' advice appears in an issue brief, in which they acknowledge that the malpractice crisis is causing physicians in some states to retire, move to other states, or give up medical practice altogether.

Several factors combined to create the current crisis, according to the brief. Among them are artificially low premiums set by insurers in the 1990s to gain market share, rising jury awards, and the exit from the marketplace of major insurance carriers, notably the St. Paul Companies.

One year in the making, the issue brief gives states short-term suggestions for dealing with the problem. The suggestions come from crisis states, such as Pennsylvania, West Virginia, and Nevada, which are profiled as case studies.

Short-term solutions that have been implemented by some states include the creation of funds from which doctors may purchase malpractice insurance; the placement of caps on noneconomic damages; alternative dispute resolution to keep medical liability issues out of the courtroom; and patient safety efforts, which would stave off malpractice claims in the first place.

The paper does not include ...