Ginny Hamm, wrote in 1999 that the facility continued to follow the practice “because administration and staff believe it is the right thing to do and because it has resulted in unanticipated financial benefits to the medical center.”3 Dr. [...] As part of the Patient Safety and Medical Liability Initiative launched in 2009, the Agency for Healthcare Research and Quality (AHRQ) funded a number of demonstration and planning grants incorporating the key patient safety themes of preventing harm through best practices, improving communication with patients, and identifying alternative methods of dispute resolution. [...] Should the patient trust the hospital to be honest, to negotiate in good faith, and to offer fair compensation? Plaintiffs’ attorneys not surprisingly point out that counsel should be involved to ensure the patient understands what has happened, what is being offered, and how to proceed wisely. [...] Insurers are accustomed to making compensation decisions based on not only whether the standard of care was violated but also the likelihood that the patient will find legal representation and prevail in a lawsuit.”7 POLICY AND L AW Legislative and regulatory activity relating to malpractice insurance occurs at the state level. [...] However, the complexity of the hospital environment and the confluence of institutional, professional, and personal considerations involved mean that change is unlikely to be swift or smooth, however honorable the goal.