The author present a discussion of the expansion of liability for medical malpractice through the erosion of traditional fault concepts. Tensions are noted between this expansion of liability and the increasing emphasis on cost containment in both the public and private sectors. Various approaches to tort reform are surveyed and analyzed with particular attention directed to comprehensive reforms recently adopted in Florida. Increased emphasis on risk management is suggested as a plausible alternative to tort reform. Finally, the employment of contractual solutions is suggested as appropriate in light of the increasingly competitive health care environment.