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Rethinking the Obvious

Time for New Ideas on Medical Malpractice Tort Reform

Gerlach, Jarrett, JD, MHA; Abodunde, Bukola, MS; Sollosy, Marc, DBA; Coustasse, Alberto, DrPH, MD, MBA, MPH

doi: 10.1097/HCM.0000000000000260

States have engaged in medical malpractice litigation reforms over the past 30 years to reduce malpractice insurance premiums, increase the supply of physicians, reduce the cost of health care, and increase efficiency. These reforms have included caps on noneconomic damages and legal procedural changes. Despite these reforms, health care costs in the United States remain among the highest in the world, provider shortages remain, and defensive medicine practices persist. The purpose of this study was to determine how successful traditional medical malpractice reforms have been at controlling medical costs, decreasing defensive medicine practices, lowering malpractice premiums, and reducing the frequency of medical malpractice litigation. Research has shown that direct reforms and aggressive damage caps have had the most significant impact on lowering malpractice premiums and increasing physician supply. Out of the metrics that were improved by malpractice reforms, similar improvements were shown because of quality reform measures. While traditional tort reforms have shown some targeted improvement, large-scale, system-wide change has not been realized, and thus it is time to consider alternative reforms.

Author Affiliation: Lewis College of Business, Marshall University, South Charleston, West Virginia.

The authors have no conflicts of interest to disclose.

Correspondence: Alberto Coustasse, DrPH, MD, MBA, MPH, Lewis College of Business, Marshall University, 100 Angus E. Peyton Dr, South Charleston, WV 25303 (

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