"Your Voice" columnist Thomas Urban's plea for malpractice and tort reform ("Lawsuit fear chases doctors away," April 4) for the sake of keeping good doctors in the Cincinnati area is the wrong answer to the problem.

Compensation rates for doctors in this area have been lower because of negotiated health insurance rates between the major employers and the health insurance companies. Some number of doctors, for this reason, have migrated to more favorable venues.

Another significant factor is that a major medical malpractice insurance carrier in Ohio squandered its assets, leaving doctors in the lurch. In spite of this, Cincinnati remains a citadel of high-quality medical care.

By decrying jury verdicts in obviously meritorious malpractice cases, health professionals are seeking to convince us that doctors can do no wrong, or at least , doctors should not be held responsible. That doesn't seem to be working very well because citizen juries haven't been frightened by the "tort reform" outcries.

What does need reforming is a little more honesty about the issues of malpractice, malpractice insurance, and disclosure to patients of possible malpractice.

For example, there occurred at one of the Mercy Hospitals, of which Urban is president, a case where a 40-year-old man was in his room after some minor surgery, and while using the bedpan keeled over. A nun/nurse was called to the room by another patient, and a code blue (emergency) call was made. Nobody came to the room, and the man died, leaving a wife and several children.

The reasons why there was not a timely response to this emergency were not given to the family. They had no idea that there may have been a failure on the part of the hospital staff. Only after one child casually mentioned the circumstances of the death of his father to a lawyer was there an inquiry. Following the inquiry, I might add, there was a fair settlement with the hospital that provided for income replacement to this family.

Hospitals have a moral obligation to reveal to patients the circumstances that produce bad outcomes. For economic reasons, they don't. Playing with all cards turned up will in the long run give hospitals and doctors more credibility and allow us to treat malpractice more honestly. Medical malpractice is the exception, but when it occurs it needs to be responded to with candor, and not propaganda.

Robert B. Newman is an attorney with offices in downtown Cincinnati.

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