Every time we walk into a clinic or hospital, an invisible tax is added to our bill. It has nothing to do with the quality of our medicine, the skill of our surgeon, or the comfort of our room. Instead, it is the direct cost of a broken legal system. The U.S. medical malpractice framework was built to help injured patients and support grieving families. Instead, it has turned into a hyperadversarial gauntlet that fails everyday families while enriching trial lawyers.
Let us be completely clear: Real medical mistakes do happen. When they do, families have an absolute right to get honest answers, full transparency, and fair payments. No sensible reformer wants to protect bad actors or take away patient rights. The tragedy of our system is that it actually hurts the very victims it was built to protect. Because of massive lawyer fees and years of grueling courtroom fights, only a tiny fraction of patients who suffer genuine harm ever get timely financial help.
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For all of us, this is a direct threat to our wallets and our neighborhood care. When local physicians are forced to order unnecessary medical tests and redundant procedures just to build a legal shield against frivolous lawsuits, we all pay the price. This practice of “defensive medicine” drains up to $162 billion from the U.S. healthcare system every year. That cash is pulled directly out of our insurance premiums, our businesses, and our tax dollars.
Worse, this constant fear of lawsuits is driving highly skilled physicians out of practice entirely or forcing them to leave high-risk areas. When our communities lose their OB-GYNs, their brain surgeons, or their dedicated family physicians because malpractice insurance premiums become unaffordable, ordinary families are left stranded. We are trading away our local healthcare access just to protect a broken courtroom system that favors financial combat over actual patient safety.
During my time leading our state’s physicians as president of MedChi, the Maryland State Medical Society, balancing professional accountability with real workforce protections was a central pillar of our mission. This ongoing fight against abusive litigation recently culminated in a major victory at the nation’s highest court. MedChi joined the American Medical Association in filing a crucial Supreme Court amicus brief to stop trial attorneys from weaponizing parallel, duplicative lawsuits in both state and federal courts simultaneously.
In a decisive 5-4 ruling in T.M. v. University of Maryland Medical System, the Supreme Court handed down a massive win for physicians by holding that litigants cannot hunt for settlements by suing doctors in federal district court while state-level proceedings are ongoing. This victory protects clear legal processes and ensures that healthcare resources are kept focused on treating patients rather than fighting off double-dipping legal harassment.
However, state-level victories are no longer enough to contain this crisis. Because federal spending heavily drives the healthcare industry through Medicare and Medicaid, we urgently need a coordinated federal framework. Unfortunately, comprehensive federal liability reform has a history of chronic inaction in Washington. Past milestone legislation, such as the Protecting Access to Care Act, which proposed uniform national liability standards to save taxpayers billions, passed the House but was left to languish and die in the Senate due to intense partisan gridlock. Congress must resurrect these dormant frameworks. Reviving federal liability rules to tie federal infrastructure grants to common-sense state litigation limits would lower the national health deficit by billions while ending the chaotic state-by-state patchwork that lets predatory lawsuits thrive.
A primary weapon in fixing this system is cleaning up how expert testimony is handled. To make sure real negligence is accurately caught, courts must rely on real, objective science, not professional “hired guns.” These are individuals who rarely practice actual medicine anymore but make lucrative careers traveling from state to state testifying against active clinicians. These professional witnesses trick juries by using unscientific standards, which harms both innocent physicians and the credibility of legitimate malpractice claims.
To stop this, our advocacy at MedChi championed a cornerstone defense mechanism known as the “25% Rule” under the state’s Health Care Malpractice Claims Act. This common-sense rule throws out any expert witness if they spend more than 25% of their professional time providing paid legal testimony. By legally barring professional witnesses, the system ensures that medical decisions are judged by active, practicing peer clinicians who actually understand the realities of a modern examination room. When combined with rigorous scientific standards, in which judges throw out junk science, frivolous cases can be aggressively dismissed while legitimate claims of negligence are evaluated with honesty and scientific integrity.
Furthermore, we must push lawmakers to change how the system handles clinical errors when they happen. The traditional legal playbook demands total silence and defensive denial. This aggressive posture drags cases out for years, torturing families who deserve answers and destroying good physicians. The path forward requires a national shift toward alternative dispute resolution and formalized communication and resolution programs.
As documented by the Maryland People’s Law Library, pre-filing and arbitration options exist to help navigate claims without endless court warfare. These frameworks encourage hospital systems to offer honest explanations, transparent disclosures, and fair compensation immediately following a legitimate medical mistake. However, the survival of these transparent programs depends entirely on the strength of state “apology laws.”
WHEN BERNIE SANDERS AND REPUBLICANS AGREE: IT’S TIME TO KILL SECRET MEDICAL BILLS
Voters and legislative aides must understand the critical legal difference at play: “Sympathy-only” laws protect basic expressions of regret but allow a physician’s honest admission of fault to be weaponized against them as evidence in court. Conversely, true “admission-of-fault” laws provide total, ironclad legal protection for honest disclosure. If we want to encourage systemic honesty and fix medical vulnerabilities before they harm the next patient, we must protect a physician’s ability to speak honestly without fear of financial ruin.
True medical reform does not mean shielding negligence. It means everyday citizens demanding that their state and federal representatives pass predictable caps on non-economic damages to stabilize insurance markets, mandate that active clinicians dominate expert testimony, and pass robust disclosure protections that favor transparency over courtroom combat. It is time for all of us to get activated, call our representatives, and help unshackle American medicine from the malpractice monster. Our access to quality care depends on it.
Dr. Eric Wargotz is a practicing physician; clinical professor emeritus of pathology at the George Washington University School of Medicine and Health Sciences; senior staff pathologist and immediate past chief of pathology and medical laboratory director at Luminis Health Doctors Community Medical Center; a judge of the Orphans’ Court of Queen Anne’s County, Maryland; former elected president of the Queen Anne’s County Board of County Commissioners; and the 178th president of MedChi. The views expressed in this article are solely his own and may not represent the official positions of any of his affiliates.
