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Editorial |

A Public Health Approach to Reducing Error:  Medical Malpractice as a Barrier

Lawrence Gostin, JD, LLD
JAMA. 2000;283(13):1742-1743. doi:10.1001/jama.283.13.1742.
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The mortality resulting from medical errors each year in the United States is estimated to be between 44,000 and 98,000—accounting for more deaths than from motor vehicle crashes, breast cancer, or acquired immunodeficiency syndrome.13 Medically induced injuries and deaths not only represent a major public health problem, but also incur economic costs and loss of trust in the medical profession. The Institute of Medicine has initiated a project on Quality of Health Care in America to redesign the health care delivery system, align incentives, and transform information technology to dramatically improve patient safety.1 In response, President Clinton proposed a national error prevention system that includes mandatory reporting of all medical errors that result in death or serious injury.4 As Mohr5 explains in this issue of THE JOURNAL, these reforms will take place within a deep historical and contemporary backdrop of medical malpractice litigation. A key issue is whether and to what extent medical malpractice creates barriers to quality improvement and, if so, what kinds of tort reforms could be helpful.

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