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Examines the impact of present and future malpractice systems on the quality of medical care. The paper is divided into four parts: (1) consideration of quality-of-care constructs; (2) an overview of those issues of medical malpractice which are pertinent to quality-of-care considerations; (3) examination of the relationship, both theoretical and empirical, between malpractice and quality-of-care; and (4) development of policy and research suggestions for understanding and altering the current malpractice system. The idea was advanced that sanctions on providers for malpractice should be separate from mechanisms for reimbursement of patients for injuries from that malpractice. The current Professional Standards Review Organization program should be strengthened by including both the public and health providers other than physicians, by covering both ambulatory and hospital care, and by extending its authority to sanction providers.
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