The state's doctors scored a major victory yesterday when the House approved a bill to set up pretrial panels to review malpractice claims before they go to court. Doctors say the panels are essential to stabilizing skyrocketing malpractice rates and keeping certain specialists, such as obstetricians and neurosurgeons, in the state.

The panels -- which are opposed by lawyers - would include a doctor, a lawyer and a judge, and unanimous panel decisions would be admitted as evidence in an eventual trial. Doctors point to a similar panel system in Maine, and 40-percent lower malpractice premiums there, as evidence that panels work to keep malpractice rates down.

Yesterday's vote marks the culmination of a two-year lobbying effort on the part of doctors and something of a surprise victory for them. Last year, a bill to establish panels died in a conference committee, and yesterday's more than two-hour debate included several amendments that would have drastically altered the proposal.

"I think people were made aware last year and sensitized to the issue," said Dr. Gary Woods, the past president of the New Hampshire Medical Society. Woods said more representatives have had personal experiences with their own doctors leaving or suffering from high premiums. The issue has come into the national spotlight recently with President Bush's proposal to limit malpractice awards.

"It's filtering around and around," Woods said. "It's not just what happens here. There's a basic awareness nationally that this is an issue."

Gov. John Lynch intends to sign the bill, according to Lynch spokeswoman Pamela Walsh. "He believes we need to watch carefully over the next few years to see what the New Hampshire experience is and make adjustments as necessary," she said.

The bill passed the House by a vote of 218-115 and will go into effect Jan. 1. New Hampshire currently has a voluntary pretrial system, but the results are not admissible in court.

Lawyers and opponents of the bill say that pretrial panels would force patients to go through two trials, lengthening the process, and they argue that higher malpractice settlements and jury awards are not what is driving premiums up. They also argue that juries would be biased from hearing a panel's decision as evidence in court, making the bill unconstitutional.

"It sets up barriers of access to our judicial system," said Jim Demers, a lobbyist for the New Hampshire Trial Lawyers Association.

Doctors say they lobbied hard, calling representatives and placing newspaper ads to get lawmakers to understand that the panels were key to keeping malpractice rates in check.

"The hope is the moderated rates would be effective over the next couple years," said Palmer Jones, the executive director of the New Hampshire Medical Society. "But logic tells you if the rates are 40 percent less in Maine, eventually they'll go down."

Jones said this year, doctors face malpractice premium increases ranging from 15 to 70 percent.

Demers said the association would ask Lynch to veto the bill and would continue to challenge it even if it passes.

"I fully expect a challenge down the road in constitutionality," he said. "I can't imagine this bill would withstand the constitutionality test."

At least twice, New Hampshire has passed laws to cap malpractice awards, but the state Supreme Court declared them unconstitutional.

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