'No fault' early offers system: seeking alternatives to traditional tort reform.(Practice Trends)

NEW ORLEANS -- A 25% reduction in malpractice premiums would do little to curb the medical liability crisis, Dr. Robert Berenson, a senior fellow at the Urban Institute, Washington, said at the annual meeting of the American College of Physicians.

At best, this cut would reduce overall health care spending by less than 0.5%, and at worst, "lead to an increase in the already large number of injured patients who receive no compensation," Dr. Berenson said.

Instead of traditional tort reforms, such as caps or reduced premiums, "physicians should be advocates for real change to the current system," he said.

Defensive medicine exists in the tort system, but "there is little deterrence of substandard and error-laden performance," he said. Injured patients are not being compensated in a reliable or timely manner, and few people involved--both physicians and patients--think justice is being served.

As much as 60% of the funds awarded in malpractice decisions never get to injured patients, he said. Instead, "they pay lawyers, experts, and court costs." A mismatch exists between those seeking compensation and those who were negligently injured. "Between 3% and 30% of injured patients actually bring claims, and most who do bring claims were not negligently injured."

Only some tort reforms that have been attempted have succeeded in serving patients and physicians. "Caps on damages are the most effective at reducing the size of awards, and, in turn, premium rates," Dr. Berenson said.

Since 1975, California law ...