The medical malpractice process can be time-consuming, costly and exceedingly slow. 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 reducing the time and effort involved. Some light may soon be appearing on the horizon.

In a malpractice case, the discovery process during which depositions take place and evidence is gathered may take years and involve several different judges. Settlement negotiations generally do not take place until the trial is impending. But in 2002, Judge Douglas E. McKeon, a Bronx County Supreme Court administrative judge, pioneered an innovative program to expedite lengthy malpractice cases.

In McKeon’s program 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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In judge-directed negotiations, a judge with malpractice expertise helps 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 and a quicker financial settlement is often appealing to both parties.

Last year the Federal Agency for Healthcare Research and Quality (AHRQ) helped fund the program with a $3 million grant, expanding the program to more New York City hospitals, and judge-directed negotiation is being viewed as a potential model for a national malpractice litigation program.

But has the program been working? Experts think so. Typical medical malpractice case take about three years, according to Michelle Mello, a law and public health professor at Harvard’s School of Public Health, whereas McKeon’s cases take an average of six to nine months. Thus far, about 200 cases have begun the process.