Intended for healthcare professionals

Feature US Medical Injury Claims

Farewell, 12 good men and true

BMJ 2010; 340 doi: (Published 16 April 2010) Cite this as: BMJ 2010;340:c1881
  1. David Payne, editor
  1. 1BMJ, London W12 9JR
  1. dpayne{at}

    Compensation for medical injury costs the US billions but, as David Payne reports, lawyers and doctors could see their earnings curtailed under a new system

    Last month Barack Obama earmarked $50m (£33m; €37m) for pilot projects that could sweep away the jury system for dealing with medical injury litigation in parts of the US, replacing them with full time judges dedicated solely to healthcare cases.1

    In a letter to Congressional leaders after the televised bipartisan summit on healthcare reform on 25 February,2 President Obama referred to the special health courts—a concept developed by Harvard School of Public Health and the legal reform think tank Common Good (

    The president’s funding pledge would allow individual states to pilot alternatives to resolving medical malpractice disputes, including health courts, which would function as administrative tribunals that use specially trained judges and neutral expert witnesses instead of juries.

    For New York lawyer and legal activist Philip K Howard, the president’s announcement was a breakthrough. Mr Howard was described recently by CNN correspondents John D Sutter and Richard Galant as an “anti-lawyer lawyer” who crusades “against the excesses of his own profession.” In 2002 he founded Common Good, a non-partisan coalition “dedicated to restoring common sense to America.”

    Mr Howard explores the commonsense theme in his 2009 book Life without Lawyers. He did so also in February this year, when he received a standing ovation at the TED (Technology, Entertainment, Design) conference in California after outlining a four point plan to fix his country’s legal system.3 The TED talk was an impassioned plea for the law to be rehumanised and simplified—for to it be judged by its effect on society rather than on individual disputes.

    In it, Mr Howard mentioned a paediatrician friend in North Carolina who told him: “I …

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