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Yesterday The New York Times featured an article about an Obama-led initiative to reduce medical malpractice costs. The process is known as judge-directed negotiation and gets judges involved before cases move towards trial. Judges with medical expertise are assigned cases early on and hold settlement conferences with the lawyers only months after the initial filing. Currently, New York is the only state employing the new legal tactic under the $3 million grant. The approach started in the Bronx, but has now moved to Brooklyn and Manhattan. In the fall, judge-directed negotiation moves outside New York City and into Buffalo, with hope that other states use New York as a model.

The approach is bound to have its fair share of supporters and critics. Michelle Melo, a Harvard law professor evaluating the process, said that the negotiations represent a major cultural change in medical malpractice cases. “Ordinarily when the parties come to a settlement conference it’s late in the game,”she asserts. “It’s often a pro forma exercise rather than an attempt to grapple with the tricky issues in the case.”

Suzanne Blundi, the deputy counsel of the Health and Hospitals Corporation, states that the average payment in medical malpractice cases last year declined to about $428,000 from $567,000 in 2003. Judge-directed negotiation “forces parties to really evaluate their case and look at the strengths and weaknesses”, Blundi stated.

On the other hand, Nicholas Timko, the president of the New York State Trial Lawyers Association, stated that the meetings can be daunting and that “there’s pressure to take less than might be fair compensation.” Under Timko’s argument, the approach is anti-plaintiff as clients do not have any say in the negotiations. In some instances, plaintiffs may feel that they are better of going to the jury.

It appears that the approach will be surrounded by debates of judicial economy v. judicial fairness. Supporters will point out the potential decrease in medical costs, such as the $1 billion estimate that the program could save if it is adopted nationally. However, others could argue that this approach may be hard to institute nationally. A key aspect of judge-directed negotiation is having a judge with better-than-average medical knowledge. While New York may have the volume of judges with this type of expertise, other parts of the country may not.


  1. Gravatar for Jim O'Hare RPLU AIC IAS
    Jim O'Hare RPLU AIC IAS

    This is very far from new and always worked that way, without any gov't handout. Anyone that has ever handled a med mal claim in New York , The Bronx or Brooklyn etc knows the Honorable judges' Clemente,Gammerman, Levine, Pizzutto,Spodek etc.

    Judge Levine used a hip prosthesis as a gavel. THey knew more and needed to, just like juries need a tad more education to understand the subtleties, the nuances and art of medicine.

    NY always had a med mal part with judges dedicated to med mal cases. THey would bang heads as loud as they needed to, in order to get a case settled. It has been that way from the early 80's.

    I always thought that is what med mal judges do; and I have been surprised ever since, that judges in other regions shy away from banging heads to get a case resolved. It is as if they have no interest in clearing their own calendars.

    Imagine a dedicated panel of justices just for med mal. It worked, and is only new to those that were not aware of it. Just do it.

    I have been adjusting med mal claims since 1985. In 1996 I started with the rest of the USA. NY is a tough place for med mal, but they got part of it right. Isnt that the fun part of being a judge?

    Jim O'Hare RPLU AIC AIS

    Dir of Claims

    Medicus Ins Co

    Austin Tx

  2. Gravatar for Noble McIntyre
    Noble McIntyre

    Jim, thanks for your insightful comment. It will be interesting to see if other states follow New York in instituting this approach.

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