Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
To the Editor: Dr Fletcher1
suggests that doctors, government, and health maintenance organizations should
collaborate more in the areas of "teaching, research, and community service."
He refers to these areas as "important aspects of health care as a whole."
But as important as attending to these areas is, any success achieved
will be short-lived unless serious attention is paid to reform of the US malpractice
system. Because the current malpractice system frightens physicians, it compels
them to practice defensively, thereby raising the cost of health care by billions
of dollars a year. It is difficult to say exactly how expensive defensive
Volpintesta EJ. Managed Care, Charity Care, and the Common Good. JAMA. 1999;282(17):1619-1621. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-17-jbk1103