The medical malpractice problem is extremely complex and is perceived very differently by health care pro viders, patients, and other segments of society. As a widely recognized problem, it is of relatively recent origin. Its poten tial societal consequences include disruption of health serv ices, waste and maldistribution of economic and human re sources, and a severe strain on a variety of our traditional social institutions. The "crisis" of malpractice is a product of many forces, including a disturbing level of negligent and improper medical care, frequently unrealistic patient expecta tions, and the growing "philosophy of entitlement" which is rampant among Americans. Responses to the problem have sometimes been ill-advised and emotional. Most often, the problem is seen as one of inadequate or overpriced malprac tice insurance, though careful analysis suggests that insurance issues are merely symptoms of the real problem. Neverthe less, insurance-based solutions have proven to be politically expedient and have produced at least temporary alleviation of the problem. Ultimately, though, other approaches will be necessary, and careful, objective research is required to iden tify and test long-term options.