The medical malpractice process is time-consuming, costly, and exceedingly slow to reach a resolution. Numerous efforts have been made to address these issues over the years, including caps on damages and statutes of limitations, however, these changes have made little difference in the time and effort involved in these cases.

Some light may be appearing on the horizon, however. In 2002, a Bronx County Supreme Court administrative judge pioneered a new program to test an innovative way to handle malpractice cases. Typically, in a medical malpractice case, the discovery process during which depositions take place and evidence is gathered can take years and involve several different judges. Settlement negotiations do not generally take place until the trial is impending.

Judge Douglas E. McKeon came up with a program whereby one judge oversees an entire case and facilitates negotiation discussions early on in an effort to save time and money for all parties. The process is called judge-directed negotiation. The program began as an agreement between McKeon and a group of public New York hospitals operated by the New York City Health and Hospitals Corporation.


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Cases would be identified as good candidates for the program and would be sent to the judge. Last year, the federal Agency for Healthcare Research and Quality (AHRQ) stepped in and helped to fund the program with a $3 million grant. This has expanded the program to more New York City hospitals. Judge-directed negotiation is being viewed as a potential model for a national program to deal with malpractice litigation.

Experts believe the program is working. According to Michelle Mello, Professor of Law and Public Health at Harvard’s School of Public Health, a typical medical malpractice case takes three years. That amount of time has been slashed in McKeon’s cases to six to nine months. In judge-directed negotiations, the judge, with expertise in medical cases, helps to facilitate the negotiations but does not impose settlement amounts.

If the parties are not happy with the process, they can opt to have the case go through the court system in the normal manner. However, the prospect of a prompt resolution of the matter, and a quicker financial settlement, is often appealing to both parties. Thus far, about 200 cases have begun the process.