Clinical Review

Here’s how we can solve the malpractice dilemma

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Copy California. The Medical Insurance Compensation Reform Act (MICRA) of 1975 has been quite successful in California (see the TABLE).2 A cap on noneconomic damages is the most important aspect of the MICRA reforms—it limits the runaway jury’s ability to award excessive verdicts.4 It is also the most difficult reform to get passed because it is perceived to limit a plaintiff ’s right to fair and reasonable compensation.


California’s MICRA reforms2

  • $250,000 cap on noneconomic damages
  • Collateral source offsets
  • Periodic payment of future damages
  • One-third-year statute of limitations/repose
  • Joint and several liability
  • Limit on contingency fees

Get ready for the next crisis. The most recent crisis has passed. Regrettably, we lost our best opportunity to have federally mandated reform in 2003 and 2004 when President Bush actively campaigned for caps and most of the MICRA reforms. When the next opportunity comes, we need to be ready.

Organize. Our malpractice premiums are up 925% since the 1970s. Our paid lobbyists and PACs have not gotten the job done. Obviously, throwing money at the problem doesn’t work. Next time, we must organize every physician nationwide to attain our political goal: to pass caps and MICRA reforms.

Your state medical society, your specialty society, and the PIAA ( have the contact numbers and e-mail addresses of your legislators. The next time this is an issue, call your legislators. They seem to listen to constituents more than they listen to lobbyists.

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