Dr. Gary Parentau grew sick of paying nearly $100,000 for malpractice insurance. So he went on strike. "Our group can't do business. We're broke," he said.

Dr. Parentau is one of about two dozen West Virginia surgeons who walked off the job this month to demand tort reform. They want lawmakers to make it more difficult to file malpractice lawsuits, thus lowering their massive premiums.

The strikers, who took 30-day leaves of absence, couldn't convince a state legislative committee, which concluded a year-long review of the issue amid the walkout and did not recommend liability limits.

The strike sent patients to hospitals across the state line. The striking surgeons say they will return to the operating room in cases of emergency; still, medical personnel went on alert to help transfer patients.

West Virginia premiums remain among the highest in the country, and doctors, hospitals, and insurers have pushed for limits to damage claims. Controversy over malpractice insurance brews in many other states, as well.

Dozens of surgeons in northeastern Pennsylvania threatened a similar strike last month, but called it off when incoming Gov. Ed Rendell pledged to fight for $220 million in temporary insurance relief. Some Pennsylvania doctors pay more than $200,000 a year for state-mandated liability insurance policies.