This article summarizes the survey findings from thirteen organizations offering alternative dispute resolution (ADR) services in medical malpractice cases. We discuss the types of disputes handled, the ADR systems used, the typical case outcomes, and the staff qualifications. We also report on the challenges and successes that these ADR programs faced, including the impact of recent legislation on medical malpractice litigation. The results highlight the central role of communication in resolving conflict following unexpected medical errors.