Seek solutions that work.

Byline: The Register-Guard

Lots of people agree that there's something wrong with the way medical malpractice is handled in the United States, but when the discussion turns to possible reforms, consensus is harder to find.

That's not surprising. The interests of the various stakeholders don't align.

What works for doctors may not suit the needs of insurance companies, which, in turn, may hope for changes that would limit what injured patients could recover in damage awards.

Doctors complain that malpractice insurance premiums are unreasonably high. In Oregon, that has led some specialists - particularly neurosurgeons and obstetricians - to limit or leave their practices, especially in rural areas.

Insurance companies claim the culprit is runaway multimillion-dollar damage awards and frivolous lawsuits.

Doctors, hospitals and the insurance industry have pushed limits on malpractice damage awards as the best solution for Oregon. But the state Supreme Court - and more importantly, the voters - have rejected that approach.

A new study suggests that Oregonians had good reason to be skeptical of the damage cap strategy.

An analysis of various malpractice reforms adopted in different states reveals surprisingly little difference in the post-reform size and frequency of malpractice damage awards. In fact, the University of Tennessee Health Science Center study deals a serious blow to the damage cap argument.

In Oregon, which has no caps on damage awards, payouts for malpractice claims are lower than in all but seven other states. The study found that caps on noneconomic damages, such as for pain and suffering, may reduce malpractice costs somewhat and lower the frequency of claims against doctors. But the limits were much less effective in lowering costs than other types of reform.

Some states with damage caps even had higher-than-average claim costs.

In addition to driving a stake through the heart of the damage cap argument, the study helpfully revealed the strategies that made the biggest difference in the number and size of malpractice payouts.

At the top of the list was establishing standards for expert witnesses. Such standards typically require expert witnesses providing testimony in a malpractice case to practice or have training in the type of medicine relevant to the lawsuit.

Researchers found that expert witness standards were three to four times more effective than damage caps. Oregon doesn't have expert witness rules.

What Oregon does have is a statute of limitations that gives patients two years from the date of discovery and five years from the date of the initial treatment to file a lawsuit. The study found that such time limits were the second most effective malpractice reform.

It's time to see the damage cap argument for what it is: a one-sided solution that benefits insurance companies at the expense of injured patients.

Doctors and hospitals ought to abandon the insurance industry's pet strategy and begin advocating for the kind of malpractice reforms that really do lower costs.