News that the Norwich OB/GYN Group is closing is evidence that the job of reforming the health care system is not over. The closing will be a hardship for the 5,000 patients who now have to seek care elsewhere. It creates a potential shortage in obstetric and gynecological care. This is on top of growing concerns about a shortage of primary care physicians. While problems specific to the practice, among them legal troubles, contributed to its financial difficulties and the closing, many local doctors can commiserate with its troubles. Malpractice insurance rates had reached $130,000 per year, per doctor, according to owner Dr. H. John Bodin. And insufficient and slow arriving Medicare and Medicaid reimbursements created money-flow problems. To control rising health care costs, the cost of malpractice insurance has to be trimmed, and that means tort reform. In addition, fear of excessive malpractice judgments drives doctors to order needless tests. While this newspaper supported the health care reform legislation, it was critical of the failure to include serious tort reform. In November, Republicans are likely to gain seats in the Senate and House. They should use that muscle to add tort reform to the health care reform package, a far more productive approach than seeking a repeal measure destined for a presidential veto. We again point to a survey by the Massachusetts Medical Society and the University of Connecticut Health Center during 2007 and 2008 that found widespread defensive medicine practices. Eighty-three percent of doctors reported practicing defensive medicine – ordering tests or sending someone to the hospital – not out of medical necessity, but for fear that if something went wrong a lawyer would upbraid them in a lawsuit. The study estimated such practices cost an additional $1.4 billion annually in Massachusetts alone. The Norwich OB-GYN Group’s problems also demonstrate the need for fair and swift government reimbursements. No health system can work without doctors.