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The malpractice crisis continues unabated in the United States. However, there are many strategies with foundations in scientific study that physicians can use to reduce their malpractice risk. Studies have shown technical error has little relationship with malpractice claims. Patients with higher education levels and socioeconomic status are more likely to file lawsuits. Surgeons should be aware of how to respond in the event a claim is filed. Improving physician-patient communication is the cornerstone of any strategy to reduce malpractice claims.