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The conventional malpractice system has many problems, and complaints about law and lawyers are hardly new.' Today, however, tort law operates on a broad scale, has widespread economic impact through liability insurance, and influences access to medical care and the nature of medical practice.2 In brief, the sometimes erratic, usually slow, and always expensive process of today's payment system undercuts its ability to compensate victims. Its failure to reach most avoidable injuries, its seemingly haphazard case-by-case determinations, and its lack of scientific legitimacy hamper its ability to deter injury. The system thus fails to achieve the two main goals of tort law.3 Moreover, providers' mistrust of the system encourages wasteful and even harmful "defensive medicine," which is the main reason for health policy concern.4 Meanwhile, quality control is unduly divorced from the malpractice

Rethinking Responsibility for Patient Injury: Accelerated-Compensation Events, a Malpractice and Quality Reform Ripe for a Test