In response to pleas from doctors struggling with the rising cost of malpractice insurance, the Legislature in 2002 passed a host of reforms. Among them were caps on some jury awards in medical malpractice cases and the elimination of a screening panel intended to weed out frivolous torts.

As far as the screening panel goes, doctors argued that the mechanism was duplicative and had done little to hold down costs or to prevent lawsuits.

Today, however, some doctors have changed their tune. With more than 300 pending medical malpractice cases in Southern Nevada, the president of the Clark County Medical Society argued this week that eliminating the screening panel was a mistake. "The panel should have been kept in place with modifications to make it more efficient and meaningful," said Dr. Michael Coletti.

Dr. Coletti points out that in 2001 --- the year before the panel was killed --- 372 malpractice lawsuits were filed in Clark County. By the end of 2002, the number was 823. It continued to increase in 2003, jumping to 1,246, before stabilizing somewhat in 2004 with 820 cases filed through November.

While the numbers seem to back Dr. Coletti's contention --- malpractice filings did indeed increase almost immediately after the panel was disbanded --- it remains unclear how the existence of the screening process would have helped physicians. Whether an allegation is vetted through a screening panel or an actual trial, significant costs remain associated with the process from the standpoint of the accused doctor and his insurance company.

But the most salient question in this debate: Where are the judges?

If, as a District Court spokesman admits, a number of malpractice cases currently pending in Clark County "probably would never have gotten this far" had the screening panel remained in place, why haven't judges already tossed them out and ordered those who filed them to reimburse the defendant for all costs?

The reluctance of judges to do precisely that --- in other words, to do their jobs --- is not unique to Clark County. It's endemic across the country and goes a long way toward explaining the litigation culture that now grips this nation in the area of medical malpractice and beyond.

The reinstatement of a state medical malpractice screening panel will do nothing to alter that dynamic.