encouraged to get on the bandwagon for tort reform in order to stop
greedy patients from ripping off the system. Although physicians supported these efforts because of the high premiums that they had to pay,
tort reform promoted managed care through the close monitoring of
physicians. Thus, to some extent, physicians worked against their own
professional interests by supporting tort reform.
The biggest winners in tort reform were the not-for-profit institutional
providers and manufacturers who stood to reduce and stabilize their
liability costs. More recently, tort reform has not been as successful at
the national level as it has been at the state level, but this may be due
more to the ideological differences contributing to Washington gridlock
rather than the lack of true public support. The parallel between the
enactment of workers' compensation at the turn of the century and the
malpractice tort reform of today suggests that medicine has indeed become much like any other industry as it attempts to reduce its liability
and increase its profits.
In the closing chapter, we will consider the implications of medical
malpractice claims for the status of physicians and their policy
implications for the legal system, clinical-level social interaction, the health care
system, and science and technology.
Robert Zussman, Intensive Care: Medical Ethics and the Medical Profession
( Chicago: University of Chicago Press, 1992).
Walter J. Wadlington, "Legal Responses to Patient Injury: A Future
Agenda for Research and Reform," Law and Contemporary Problems 54, no. 2
( 1991): 199-223; W. Kip Viscusi and Patricia Born, "The National Implications of
Liability Reforms for General Liability and Medical Malpractice Insurance," Seton
Hall Law Review 24 ( 1994): 1743-66.
This would prohibit receiving compensation from more than one source.
For example, one could not claim compensation from both health insurance and
a court award. Any health insurance payments related to the injury would be
deducted from the malpractice award.
Viscusi and Born, "National Implications."
Michael Pferr, "Medical Malpractice Legislation--1985 to 1988," Issues in
Focus 89-117 ( Albany, N.Y.: Senate Research Service, 1989), 2.
Joseph M. Jacob, Doctors and Rules: A Sociology of Professional Values ( New
York: Routledge, 1989).
David W. Leebron, "Final Moments: Damages for Pain and Suffering Prior
to Death," New York University Law Review 64 ( 1990): 306. Leebron found that
the pain and suffering portion of 256 civil awards was higher for female claimants because they were seen as more prone to pain and suffering. See also Thomas Koenig and
Michael Rustad, "His and Her Tort Reform: Gender Injustice in
Disguise," Washington Law Review 70, no. 1 ( 1995): 1-94. Koenig and Rustad