For more than a decade, professional liability, often inappropriately labeled "malpractice," has bedeviled all physicians regardless of their specialty or indeed their recognized competence. Critics repeatedly charge the profession with failing to deal with the problem, while at the same time state that joint underwriting associations and "surplus lines" companies make it possible for physicians to obtain insurance, not infrequently ignoring evidence of substandard performance or extensive claims history. More recently, an attack has begun on the insurance industry as the root cause of professional liability expense. With 42 physician-owned and -controlled professional liability companies, it is blatantly unlikely that these companies would not adhere to lean insurance principles often having to follow the mandates of the very insurance commissioners now critical of their performance.
Elsewhere in this issue, Schwartz and Mendelson1,2 present important previously uncollated demographic data suggesting that physician-owned insurance companies, once, but no longer, derogatorially known