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Ideas and Opinions |

Malpractice Reform Must Include Steps To Prevent Medical Injury

Stephen C. Schoenbaum, MD, MPH; and Randall R. Bovbjerg, JD
[+] Article and Author Information

From The Commonwealth Fund, New York, New York, and The Urban Institute, Washington, DC.


Disclaimer: All opinions are the authors' own and should not be attributed to The Commonwealth Fund or The Urban Institute, or their respective directors, officers, or staff.

Potential Financial Conflicts of Interest: None disclosed.

Corresponding Author: Stephen C. Schoenbaum, MD, MPH, The Commonwealth Fund, One East 75th Street, New York, NY 10021; e-mail, scs@cmwf.org.

Current Author Addresses: Dr. Schoenbaum: The Commonwealth Fund, One East 75th Street, New York, NY 10021.

Mr. Bovbjerg: Health Policy Center, The Urban Institute, 2100 M Street, NW, Washington, DC 20037.


Ann Intern Med. 2004;140(1):51-53. doi:10.7326/0003-4819-140-1-200401060-00011
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In the current malpractice insurance crisis, physicians have focused their advocacy and energy primarily on rapidly increasing liability premiums; problems in access to care; and demands for legal reform, especially caps on damages. An even more important focus, however, is prevention of injury and improvement of patient safety. Physicians largely control patient care and can play a critical role in systematically reducing injury. Reforms should go beyond liability issues; they should also harness and enhance physicians' ability to act. More visible efforts by physicians to reduce harm, better communication with patients and others, and true evidence of improved patient safety should reduce patient anger and litigiousness. Individually and collectively, physicians can and should ensure that “doing no harm” comes first in the malpractice debate.

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