Summary: As part of a larger goal of reducing health care costs and improving medical care, Maine is testing an innovative medical malpractice reform initiative. Maine has incorporated into state law 20 practice guidelines for four specialties: anesthesiology, emergency medicine, obstetrics and gynecology, and radiology. This effort seeks to resolve malpractice claims by eliminating the need to litigate to establish the standard of care. Maine officials expect that the practice guidelines will decrease doctors' motivation to do medically unnecessary tests and will lower health care costs. Maine was able to incorporate the practice guidelines into law by (1) gaining broad involvement of those affected by the guidelines, (2) ensuring that those developing and choosing the guidelines were accountable to the public, and (3) protecting the physicians who use the guidelines in their practice. Specifically, the project was developed and is overseen by health care providers, payers, and consumers. To persuade Maine's doctors to participate in the project once it was developed, the project provides physicians complying with the guidelines a defense in future malpractice lawsuits. With these components, the majority of eligible doctors opted to participate in the project.
