From 2008 to 2011, Tennessee implemented medical malpractice reforms due to rising insurance rates and concerns that the state would lose doctors.

The reforms included a cap on noneconomic damages (such as pain and suffering) of $750,000, which is on the high side of most state caps on damages. The reforms also included a certifying process requiring attorneys to certify that a medical expert had evaluated the claim and found it had merit. What has been the effect of these reforms?

For physicians, the reforms have had positive effects: For every medical specialty in the state, insurance premiums have dropped since 2009. Additionally, supporters point out that the number of medical malpractice lawsuits filed in Tennessee each year has dropped by 36% since the reforms went into effect. The state medical association claims this is evidence that a change was needed and this will help patients get access to medical care. But plaintiffs’ attorneys are not happy, and claim that the reforms favor doctors at the expense of injured patients.


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“What people in Tennessee don’t understand is there has been an effort to take away their rights to access the courthouse,” Bryan Smith, President of the Tennessee Action for Justice, a lawyers group, said in an article. Smith and other attorneys claim that the complex certifying process required to file a malpractice suit is causing attorneys to avoid malpractice cases. Plaintiffs’ attorneys also complain that the cost of trial preparation and to hire experts is prohibitive when a cap on awards is in place.