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June 5, 1991

Medical Injury Compensation A Time for Testing New Approaches

Author Affiliations

From the University of Virgina School of Law, Charlottesville.

From the University of Virgina School of Law, Charlottesville.

JAMA. 1991;265(21):2861. doi:10.1001/jama.1991.03460210107041

Despite an improved climate for professional liability insurance, medical injury compensation remains a subject of serious concern. The current tort system has been assailed as too slow, too costly, too complicated, and inconsistent in awards. Some critics assert that it induces overutilization through "defensive" medicine while limiting access by influencing physicians to forgo high-risk procedures or to shift to specialties with less liability exposure. Many medical practitioners also contend that it often stigmatizes physicians unfairly.

Legislative reform in the 1970s and 1980s produced changes in the tort system in response to perceived crises arising from the increasing cost and diminishing availability of professional liability insurance. Because of limited understanding about the nature and dimensions of the problems at which they were directed, it was highly conjectural whether those remedies would effect anything close to a cure.

Today's situation differs significantly. We now have a significant body of research, and such