Enterprise Liability and the Emerging Managed Health Care System

“Enterprise medical liability” is a term used to describe a system in which health care organizations bear responsibility for medical malpractice in addition to or instead of individual health professionals. Enterprise liability is in many senses a natural outgrowth of the increasing dependence of medical practice on institutional resources and expertise.2 Proposals for enterprise liability surfaced briefly from the academic literature into the political spotlight during the 1993-94 health care reform debate. At that time, objections to the concept as a basis for medical malpractice liability, even in a restructured health care system, were nearly universal. Just five years later, many of the groups vehemently opposing the Clinton malpractice reform have become vigorous supporters of managed care liability. Moreover, courts and legislatures are holding managed care