An impending exodus of doctors from Maryland because of skyrocketing malpractice insurance rates has created a crisis that needs an immediate solution, Gov. Robert L. Ehrlich Jr. declared at a news conference yesterday.

Flanked by a half-dozen doctors in white coats and scrubs from the Anne Arundel Medical Center in Annapolis, Ehrlich (R) called for a special summer meeting of the legislature to address a looming 40 percent rate increase by the insurance company that covers most Maryland doctors.

"In my view, the legislature needs to act now," Ehrlich said. "They need to sit down and work this out now. The crisis is affecting citizens now. There needs to be a special session now."

Maryland joins dozens of states and the District in trying to respond to the troubles posed by rising malpractice insurance rates, which some state officials say are the result of a mounting number of lawsuits and costly judgments for patients who have had bad outcomes.

The issue ranks among the most contentious before Maryland leaders this summer, rivaling the dispute over slot machines in terms of lobbying clout. Three powerful political constituencies -- doctors, insurance companies and trial lawyers -- have been locked in conflict over how best to resolve the issue.

Ehrlich said yesterday that he remains convinced of the merits of a proposal he made to the legislature this year that focused exclusively on limiting the money insurance companies would have to pay malpractice victims who prove in court that they were harmed by the negligence of doctors or hospitals.

Among its provisions: a reduction in Maryland's cap on damages for pain and suffering from $635,000 to $500,000 and further limits on the amount victims could collect for future medical expenses.

But the proposal did not pass muster with the state Senate, which is led by lawyer Thomas V. Mike Miller Jr. (D-Calvert).

Trial lawyers have argued that the ability to sue is the most effective way to hold doctors accountable for costly mistakes. Sen. Brian E. Frosh (D-Montgomery), a lawyer who chairs a Senate task force studying the issue, has said in past interviews that he has seen evidence showing that insurance reforms, not liability caps, are the most effective way to drive rates down.

The committee Frosh chairs voted down Ehrlich's proposal, calling it "a bad bill" that "wouldn't have significant impact on malpractice rates" but would be "really punitive to the victims of malpractice."

At yesterday's news conference, Ehrlich indicated that a compromise may be possible, so long as some of the framework of his proposal remains intact.

"We need a balance," the governor said. "To the extent observers will say it's not simply a matter of tort reform, I agree. We welcome balance. We welcome a comprehensive solution."

Ehrlich appointed members to a new task force to seek a solution -- it's the second group to meet this summer on the matter. His call for a solution in a special session will depend on the task force's ability to quickly draft a proposal that wins not only his support but also backing from Senate and House leaders.

Ehrlich said he does not know whether that will be possible. But what's not in doubt, he said, is that a solution is needed soon. For years, the state's insurance rates had been relatively stable. But in the past two years, claims paid by the Medical Mutual Liability Insurance Society of Maryland jumped, from $49.5 million for all of 2001 to more than $73 million in the first 10 months of last year, said David L. Murray, president of the company, known as Med Mutual. Last summer, Med Mutual sought and won a 28 percent increase in malpractice premiums, the most dramatic rise in years.

Next week, Ehrlich said, the company is expected to request another increase, this one in the range of 40 percent.

Henry Sobel, chairman of the Anne Arundel hospital's obstetrics department, said that would spell disaster. More than 80 percent of his department is involved in lawsuits, he said, and he's lost 10 percent of his staff in the past year.

Rate increases forced obstetrician Carol Ritter to take down her shingle after 20 years in practice in Towson. Ritter appeared with the governor yesterday to call for an end to the political deadlock. In one year, Ritter said, her insurance premiums rose from $60,000 to $120,000, meaning 85 percent of her office revenue would be going to pay her insurance bill.

"There were many tears, many tissue boxes," she said of shuttering her practice. "But no matter how much you love your job, no one would work under these conditions."