Addressing the malpractice problem: The Robert Wood Johnson Foundation's Program

J. C. Cantor, W. J. Wadlington

Research output: Contribution to journalShort surveypeer-review


The Robert Wood Johnson Foundation's Medical Malpractice Program has contributed significantly to what is known about the dimensions of medical error, how medical providers perceive and respond to the current malpractice system, and the ways in which the problems of the current system may be overcome. Even this substantial body of research, however, does not answer all of the important questions raised by policymakers, health care managers, and medical practitioners. Nevertheless, several generalizations can be made from the studies supported under the Medical Malpractice Program: (1) Provisions in the health care and legal systems to identify, prevent, and compensate for medical injuries are seriously flawed; indeed, the great majority of injuries go unidentified. (2) Various stakeholders may perceive malpractice-related problems differently. For example, medical providers see the system as arbitrary, while policy analysts emphasize lost opportunities for stronger incentives to prevent injuries and to compensate injured parties fairly. (3) Risk management and related mechanisms can be effective, but they are not broad-based and active enough to make a significant contribution to reducing medical malpractice. (4) The best opportunities to prevent medical injuries are in changes to the organization of care rather than in targeting 'bad-apple' providers. (5) Current methods of claims adjudication operate more fairly than many have suggested, but the system is slow, expensive, and adversarial, which compounds dissatisfaction with the system. Alternative dispute resolution techniques have not been adopted widely. (6) There exist promising new approaches to address malpractice problems that are ready for implementation, at least on a demonstration basis.

Original languageEnglish (US)
Pages (from-to)229-240
Number of pages12
JournalHealth Affairs
Issue number5
StatePublished - 1994
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Health Policy

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