[Medical] error rates are too high. They're too high compared to other industries. And they're too high compared to what logically is possible.
Donald Berwick, MD, Institute for Healthcare Improvement1
Physicians and health care risk managers should be concerned whenever quality medical care is not being provided. One of the responsibilities of health care risk managers is to investigate medical malpractice claims.2 This process often involves questioning physicians' patient management to ascertain whether the standard of care was met. The purpose of the risk manager's inquiry is to determine the merits of the malpractice claim and to improve the quality of future medical care by reducing any unwarranted risks. Many physicians resist such inquiries, because they view them as threatening their professional autonomy. As a result, these physicians often mistrust risk managers. This mistrust combined with the omnipresent threat of medical malpractice litigation discourages physician involvement in risk