For some ailments, doctors can't provide a cure - only a way to manage the pain. Case in point: the crisis of rising medical malpractice costs in Pennsylvania.

The need for malpractice coverage can't be erased, but sound legal and policy moves have made the state's health-care climate far less troubled.

Among the improving vital signs, as noted in an article last week by Inquirer staff writer Josh Goldstein:

Malpractice lawsuits have declined by more than a third, with a steeper drop in suits filed in Philadelphia's reputedly plaintiff-friendly courts.

For the first time in several years, major insurers ruled out malpractice rate increases this year.

In addition to moderating rates, physicians have been helped for three years by an annual $220 million subsidy covering surcharges owed the state's Mcare Fund, which handles large malpractice payouts. Meanwhile, Mcare awards for malpractice are down substantially.

Anecdotes about doctors fleeing the state may persist, but patients in this region - once the supposed hotbed of malpractice abuse - are usually able to find the physicians they need.

Those are impressive strides, since Pennsylvania was ground-zero in President Bush's first-term effort to enact legal reforms that would cap medical damage awards.

It turns out that, given time, the more moderate steps taken by Harrisburg lawmakers and the state courts to limit suits and ease the cost crunch produced genuine results.

Don't look for medical caps to vanish from the Republican agenda, but they would be no more helpful in cutting insurance costs now than before. And such draconian limits on patients' rights are even less justified, given the progress in easing the malpractice crisis.

There's still much work to be done. Insurance reforms that would include sharing the premium burden more evenly across medical specialties - or providing other aid to physicians in hard-hit specialties - could prevent the spikes in cost that raise docs' temperatures.

In terms of resolving disputes, it would be far better - as Gov. Rendell urges - to take malpractice claims first to mediation rather than trial. Some hospitals have begun experiments in such procedures.

Physicians and hospital officials may not be ready to concede that the malpractice crisis they hyped so frantically has waned. But many of them deserve credit for stepped-up efforts to reduce medical errors - until recently, a little-acknowledged means of heading off malpractice claims by safeguarding patients.

Through the Delaware Valley Healthcare Council's efforts on behalf of local hospitals, this region is becoming a leader in patient safety by targeting medication errors and infections. State officials, meanwhile, are promoting patient safety with greater scrutiny of medical errors.

The emphasis on improved patient care should prove helpful in avoiding the next malpractice insurance crisis.