In "Finding a Balanced Approach to Malpractice" [Close to Home, Aug. 14], James Rivers and Richard Anderson cited a survey that measured physicians' feelings about the risks of medical malpractice lawsuits.

But a study conducted by Public Citizen in 2004, "The Facts About Medical Malpractice in Maryland," provides dates, dollars and cases. It found that lawsuits are not responsible for the rising medical malpractice premiums in Maryland. In fact, the dollar amounts of judgments against Maryland doctors remained fairly level from 1994 to 2004; if adjusted for inflation, they actually have declined.

The Public Citizen study also found that few of the approximately 19,000 licensed physicians in Maryland have ever been sued. What is worrisome is the tiny number of physicians who repeatedly lose malpractice lawsuits and how little is done to discipline them.

Also, Medical Mutual, the insurance company that writes most malpractice insurance in the state, is owned by Maryland's physicians -- a peculiar arrangement that casts doubt on the company's objectivity.

Yes, medical reform is needed, but not the emotion-based bandages that Drs. Rivers and Anderson suggested. Medical reform must be based on reality. The facts and conclusions of the Public Citizen study provide us with a good beginning.