WASHINGTON – At a forum organized by Common Good, with support from the Robert Wood Johnson Foundation, held Thursday in Washington, DC, stakeholders and experts on medical liability issues discussed ways reform could lower healthcare costs in the U.S. and improve patient safety.

The forum comes as the Department of Health and Human Services' launches a $25 million initiative to test patient safety and medical liability innovations, and Congress debates medical liability reform as a potential way to bend the cost curve on escalating healthcare costs.

The experts at the forum, including national legal, medical and policy experts agreed medical malpractice suits are a continued threat to patient safety. They put doctors on the defensive, are the root cause for doctors using more expensive and sometimes unneeded care, and cost billions a year in malpractice insurance and case settlements. Medical malpractice cases set up an environment that does not welcome room for quality improvement or analysis of near-miss incidents.

Philip Howard, a law partner at Covington & Burling in Washington, DC and chair of the Common Good, said the current system makes it easy for patients to bring claims against doctors.

"Fear has dramatically changed culture of healthcare in ways that are staggeringly unproductive for cost and quality," Howard said.

Howard and some of the others on the panel hold out one possible solution that would call for health systems to pay for harm rendered based on a preset scale.

Admitting to the harm and helping to explain to the patient or patient's family what happened and then compensating them for damages is ultimately cheaper in the long run and prevents lawsuits that often disrupt both parties' lives for five or more years, experts said.

According to Richard Boothman, chief risk officer at the University of Michigan Health System, the U. of M. Health System has made headway using such a program, Boothman said.

"Once you give patients a chance to hear the explanation of what happened, they are far more forgiving than we give them credit for," Boothman said.

The U. of M. Health System also does extensive informed consent prior to patients' receiving potentially dangerous treatment.

Boothman said changing the hostility of the environment, and protecting physicians ahead of time, has done a lot toward cultivating provider willingness to come forward to report near miss situations and to prevent harmful events in the future.

"The biggest cost of medical liability is the chilling effect it has on any professional improvement," Boothman said. "You can't say 'I didn't do it,' and say 'how could I have done better?' at the same time. They can't coexist."