By DR. WILLIAM W. LANDER

Pennsylvania is the proud home of some of the best medical institutions and most respected doctors in the world. Yet, today, our health-care system is in crisis. Unpredictable and often outrageous jury verdicts have become commonplace in malpractice cases. According to data from the U.S. Health Resources and Services Administration, payouts for malpractice claims against doctors in Pennsylvania climbed to an all-time high in 2004 – $448 million. That’s a 14 percent jump in one year, and almost double the payouts of 10 years earlier.

Faced with increased liability and skyrocketing malpractice premiums, some of our doctors are giving up the practice of medicine, especially those in high-risk specialties such as obstetrics, surgery and emergency care. 

Other health-care providers are increasingly practicing defensive medicine, adding cost to an overburdened health-care system, in order to avoid potential lawsuits.

Fear of litigation stymies the flow of information among doctors and hospitals, and stalls efforts for peer review and quality systems improvements.

Unfortunately, the current system doesn’t provide appropriate or timely compensation to those truly experiencing medical malpractice.  Instead, it rewards a few lucky plaintiffs and their attorneys. 

Those eventually compensated will have suffered an average of four years of litigation.

The current medical justice system is not working for doctors or for patients.  Pennsylvania needs a more effective, comprehensive solution – one that will overhaul the current system, resulting in one that is more consistent and reliable.

One of the most promising solutions for this problem lies in an innovative and bipartisan initiative that’s building momentum in Pennsylvania and around the country – the creation of special health courts.

Special courts already exist for tax disputes, worker’s compensation, bankruptcy and vaccine liability. Why not for health care as well?

The hallmark of special health courts – a concept advanced by the national bipartisan reform group Common Good (www.cgood.org) – would be trained judges, selected by a nonpartisan panel for their expertise in health care. 

Dedicated solely to addressing medical malpractice cases, these judges would develop standards of care with the help of neutral experts. The experts would be hired by and accountable to the court – not to one particular side of the dispute.

Together, these judges and experts would bring medical training and knowledge that a jury could not.

While some personal-injury lawyers fear the pinch special courts could put on their wallets, victims would still be fully reimbursed for their medical costs and lost income (economic damages), plus a fixed sum that could be predetermined according to a schedule that distinguishes between types of injuries. 

A panel of experts would create this schedule and update it periodically.

Special health courts would also streamline proceedings and lower the costs of litigation. Most cases would be resolved within months, not years.

Establishing special health courts is a win-win solution, and this may be why the momentum behind it is broad and bipartisan. 

Both U.S. Senate Majority Leader Bill Frist, R-Tenn., and the Progressive Policy Institute, known in the 1990s as President Clinton’s “idea mill,” have endorsed the concept. 

So have more than 80 leaders in American health care.

The idea also appeals to the public.  According to a Harris Interactive survey released last year, nearly two-thirds of Americans support the idea of having malpractice disputes resolved in special courts.

Special health courts would restore reliability and consistency to the medical justice system.  They would fairly compensate victims, and weed out patients without valid claims. 

They would protect the many doctors who practice good medicine, and better identify those few who don’t. 

They would reduce health-care and litigation costs, and increase openness and candor among health-care professionals. 

Once implemented, special health courts would help protect the doctor-patient relationship.

It’s time for Pennsylvania to take steps to act on this much-needed reform – before it’s too late.



Dr. William W. Lander, a family practice physician, is president of the Pennsylvania Medical Society.