DEFENSIVE MEDICINE AND TORT REFORM - NEW EVIDENCE IN AN OLD BOTTLE

Quantitative analysis of medical liability's influence on medical prac tice is a small but growing field. The three foregoing articles illust rate three of the possible analytic approaches: case study of technolo gical diffusion, survey of physician responses to detailed clinical sc enarios, and multivariate analysis of the relation of physicians' scen ario responses to objective liability experience. The articles also of fer a good picture of the state of the art. Many difficulties hamper r esearch in this area, and these articles, like others, offer considera ble illumination but leave much uncovered. Defensive medicine surely e xists, but its effects on health care spending and access are unclear. The most important lessons for public policy are that tort reform may be necessary but not sufficient to reduce the problems associated wit h defensive medicine, and that the major malpractice problem continues to be malpractice.