The conventional wisdom among patient safety advocates and medical scholars is that medical malpractice lawsuits impede efforts to improve health care quality by encouraging providers to hide mistakes. This belief provides the normative basis for ongoing efforts to curtail medical malpractice exposures. Groups pressing medical malpractice lawsuit reform contend that when doctors and other providers are insulated from medical malpractice liability, patients will be better protected from harm. This article canvasses the evidence bearing on the connections between malpractice exposure, error reporting, and health care quality. Some evidence, such as the Harvard Medical Practice Study and its following researches shows that malpractice lawsuits sometimes cause the quality of health care to decline. However, other evidence, such as the history of anesthesia safety shows that the quality of health care improves as the risk of being sued rises. The other evidence related to error reporting and defensive medicine doesn't show clearly whether fear of malpractice lawsuits discourages error reporting and whether a doctor orders a test or procedure that has little or no utility for a patient solely to reduce the risk of a lawsuit. This article concludes that it seems appropriate to make medical malpractice dispute resolution into a more effective vehicle for serving the interest of patients and doctors. The malpractice system should clearly do this, for we all will be medical patients some day.