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Bmj Usa: Editorial

Montezuma's treasure

BMJ 2005; 331 doi: (Published 15 December 2005) Cite this as: BMJ 2005;331:E395
  1. Richard G Roberts, professor of family medicine (
  1. University of Wisconsin School of Medicine and Public Health, Madison, WI

    Has Mexico found malpractice gold in conciliation-arbitration?

    Tena-Tamayo and Sotelo report in this issue (p 528) on Mexico's conciliation-arbitration system for handling malpractice disputes. Their report reminds us that finding the perfect medical liability system is like panning for gold—it is a global endeavor with a low chance of success finding a mineral that fluctuates widely in value depending on time and place. What works well in one locale may not in another.

    In 1996, Mexico's president established Conamed in the Ministry of Health to arbitrate malpractice cases. Conamed is sponsored by the government, provides expert opinion on negligence, and referees malpractice disputes. Both parties must consent to participate, and if agreement is reached, the case cannot be taken to the civil courts. Averaging 5000 cases per year, Conamed has resolved three fourths of its cases within 48 hours, and more than 90% of claims conclude without either party proceeding to court.

    Have the Mexicans stumbled onto Montezuma's gold with a system for the speedy, inexpensive, and effective resolution of medical malpractice disputes? Sadly, no. What works well in Mexico has not been as effective in …

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