BOX 3-7 The IOM on Tort Reform

For the first time in nearly 20 years, the United States is facing a broad-based crisis in the availability and affordability of malpractice liability insurance for physicians, hospitals, and other health care providers. Although liability is intended to provide a system of accountability, there is widespread agreement that the current system of tort liability is a poor way to prevent and redress injury resulting from medical error.17

The randomness and delay associated with the present pattern of accountability not only prevents severely injured patients from receiving prompt and fair compensation, but destabilizes liability insurance markets and attenuates the signal that liability is supposed to send health care providers regarding the need for quality improvement. The shortcomings of the current malpractice system come from three directions, all of which have contributed to the present crisis: inefficient and inequitable legal processes for resolving disputes, problematic responses by clinicians to the threat and cost of liability, and volatile markets for liability insurance.

The best way to create a legal environment that fosters both high-quality patient care and relieves financial strain and administrative burden for health care providers is to replace tort liability with a system of patient-centered and safety-focused nonjudicial compensation—linking claims resolution to organization-based error disclosure and safety improvement processes.

SOURCE: Committee on Rapid Advances Demonstration Projects: Health Care Finance and Delivery Systems, Fostering Rapid Advances in Health Care, IOM, 2003.

From: 3, Improving Breast Cancer Screening Services

Cover of Saving Women's Lives
Saving Women's Lives: Strategies for Improving Breast Cancer Detection and Diagnosis.
Institute of Medicine (US) and National Research Council (US) Committee on New Approaches to Early Detection and Diagnosis of Breast Cancer; Joy JE, Penhoet EE, Petitti DB, editors.
Washington (DC): National Academies Press (US); 2005.
Copyright © 2005, National Academy of Sciences.

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