Mixed results in medical liability ballot initiatives: voters approve caps in Nevada but not in Oregon or Wyoming; Florida limits attorney contingency fees.(Practice Trends)

Physicians got mixed results when they took the issue of medical liability reform to the voters this year. Voters approved caps on noneconomic damages and other reforms in Nevada and passed limits on attorney contingency fees in Florida, but failed to enact damage caps in Oregon and Wyoming when they went to the polls last month.

John C. Nelson, M.D., president of the American Medical Association, said there is widespread support for medical liability reform across the country and that even those ballot initiatives that failed this year were defeated in tight votes.

The AMA continues to focus on reforms at the federal level, where the reelection of President Bush and Republican gains in the Senate could help move this issue forward.

"We will be relentless in pursing this," Dr. Nelson said.

It's important for physicians to continue to support reforms at both the state and federal level, said Michael O. Fleming, M.D., immediate past president and board chair for the American Academy of Family Physicians.

Even though federal reform is critical, Dr. Fleming said, states should continue to pursue solutions that work at the local level. For example, in Dr. Fleming's home state of Louisiana, the state has a medical review panel that evaluates malpractice cases before they go to trial. This approach has worked well, he said.

The success of ballot initiatives in places such as Florida and Nevada will also provide additional information about how to stabilize the insurance market that could be useful at the federal level, said Patrick Hope, legislative counsel for the American College of Physicians.