Soaring malpractice insurance premiums led New Jersey physicians to stage walkouts earlier this year. In neighboring Pennsylvania, a statewide work stoppage was averted only by last minute deal making. Doctors and insurers blame multi-million dollar lawsuits and are calling for caps on pain and suffering awards in malpractice cases. Consumer activists and victims' lawyers say that letting bad doctors off the hook is no solution. They note that more than half of all payouts are from a small number of doctors and yet even the worst offenders rarely get disciplined. They say the answer is better policing, not higher premiums.