ORDINARILY, MARYLAND doctors are not given to a primal scream, but these are not ordinary times. When doctors at Prince George's Hospital Center voted unanimously Monday night to ask that hospital officials permit them to drop their malpractice insurance coverage, that was a howl of frustration. The doctors, who were hit by a 28 percent increase in their malpractice liability premiums this year, now face a further 41 percent increase in the coming year. Obstetricians and others in lawsuit-prone specialties will be paying annual premiums of well over $100,000, an amount that some say will drive them out of their practices, or maybe out of state. Hence the primal scream.

As the Prince George's doctors knew before they voted, there is little chance the hospital will let them keep working without coverage -- "go bare," as it is known among physicians. Going bare would shift the liability risk in lawsuits to the hospital, which has its own financial problems. Even if only some doctors dropped their insurance, they could wreak havoc in the workplace: Would an anesthesiologist want to go into an operation with a surgeon who lacked insurance? Nonetheless, even as a symbolic gesture the doctors' vote packed a punch. It served as a reminder -- to Gov. Robert L. Ehrlich Jr., to the General Assembly, and to hospitals, insurers and trial lawyers -- that the clock is ticking on their search for a solution. Doctors expect to receive their first bills for next year's premiums in November; as it happens, that is also when commissions appointed by the governor and the Maryland Senate are expected to deliver their recommendations on defusing the state's malpractice liability bomb.

Unfortunately, there is no particular cause for optimism at the moment. Mr. Ehrlich first characterized the impending rate increase as a "crisis" and called for a special session of the state legislature. But lately he has played politics with the issue, calling on doctors to lean on state lawmakers. Predictably, that aroused the resentment of trial lawyers, who are suspicious that the governor is more interested in grandstanding than in resolving the problem. Trial lawyers had refused to serve on the governor's 19-member malpractice liability commission, leaving it even more heavily tilted in favor of doctors, hospitals and insurers than it was already. The commission's chairman, retired state appeals Judge Raymond G. Thieme Jr., says that if Maryland trial lawyers boycott his panel's proceedings, he may be forced to call on out-of-state trial lawyers to appear.

Doctors support tort reform -- lowering the cap on non-economic damages that juries award injured patients -- but that's only one part of the problem. Any realistic settlement must also include insurance reforms and better policing of the medical profession and repeat-offender doctors. Mr. Ehrlich could score easy political points by bashing trial lawyers and big jury verdicts, but by doing so, he is unlikely to break the impasse on one of the knottiest problems facing the state. Lately he has shown signs in private meetings that he is serious about finding a compromise. Let's hope so. Otherwise many more Marylanders will be joining in the primal scream.