• John J Smith and R James Brenner.
• Med-Tel International, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA. johns@medtel.com <johns@medtel.com>
• J Am Coll Radiol. 2004 Apr 1;1(4):249-54.

AbstractAs described in the previous article in this series, the United States is in the midst of a medical liability insurance crisis. Research conducted in the wake of similar previous insurance environments has shown that only a fraction of patient injury as a result of negligent medical care is addressed by today's tort malpractice system. This large reservoir of potential malpractice cases, coupled with the inevitable cycles of the economy and insurance markets, means that current action is mandatory to prevent another, even more serious crisis in the future. A variety of potential solutions have been proposed, including reform of the existing tort malpractice system, a no-fault compensation system, and so-called hybrid systems that combine tort and no-fault. These mechanisms should be evaluated in terms of three key factors: (1) the adequacy of compensation to injured patients, (2) the prevention of future medical injury, and (3) their overall cost and administrative feasibility. Whatever reform mechanism or combination of mechanisms is pursued should represent an improvement on today's existing tort malpractice system.

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