CHARLESTON — At the sunny entrance to Roper Hospital, Gov. Mark Sanford on Monday ended a multiyear fight for laws making it harder to win big payments from businesses and doctors.

Sanford signed a law that limits pain-and-suffering damage awards in medical malpractice cases to no more than $350,000.

The law is the second of two such measures lawmakers passed this year after several years of lobbying by business leaders and doctors. Sanford last month signed the first, which made it harder to sue businesses.

Supporters said both laws make South Carolina a friendlier place to do business and to practice medicine.

Monday’s ceremony was held outside Roper Hospital’s emergency room entrance. Doctors and lawmakers applauded as Sanford signed.

“This bill is fundamentally about lowering the cost of medicine so more people can be covered and about having medicine be practiced by doctors — not by lawyers,” said Sanford, whose father was a doctor.

Doctors had lobbied for the law for more than three years. They said big lawsuit payouts were driving their insurance rates so high that many were quitting high-risk practices — leaving communities with a shortage of neurosurgeons and obstetricians.

J. Chris Hawk was one of those doctors. Two years ago, the general surgeon stopped performing vascular surgery, a relatively risky procedure, to get a 20 percent drop in the cost of his malpractice insurance.

Hawk watched Sanford with a sense of relief. He had considered retiring because of skyrocketing insurance and fear of being sued, and he was worried about the future of his two children, who also are in medical careers.

“The biggest thing we need to do is fix the legal system,” Hawk said. “It’s broken.”

But advocates for patients and for reducing medical errors say capping non-economic damages removes one of the incentives for doctors to not make mistakes that lead to lawsuits.

“The fear of victims like me is that it will remove accountability from the system,” said Helen Haskell, of Columbia.

Haskell’s son, Lewis Blackman, 15, bled to death four years ago because of an adverse drug reaction after surgery. The negligence by workers at the Medical University of South Carolina Children’s Hospital was so clear that MUSC paid Lewis’ family $950,000 without going to trial.

A bill named for Lewis that is now in a House subcommittee would require hospital staff to wear badges identifying their experience level.

Doctors and lawmakers at Monday’s ceremony said the damages cap was only the first step.

Sen. President Pro Tem Glenn McConnell, R-Charleston, said more reforms are needed. He supports changes resembling the workers’ compensation system, which would allow doctors and patients to work through disputes without going to court.

The new law will help keep insurance rates down for now, McConnell said, but “we need to step back and figure out a better system.”

South Carolina joined several other states in changing medical malpractice and business liability laws. President Bush has helped raise the issue’s profile nationally, as well.

Opponents have said the laws will hurt people’s ability to be compensated if they are hurt by businesses or doctors.

Sanford said the laws will make South Carolina more competitive for jobs.

“In the past two weeks, we’ve made significant upgrades to both our business and our medical malpractice” laws, he said, “improvements that are going to have a direct return in terms of jobs, capital investment and access to health care.”

Reach Talhelm at (803) 771-8339 or jtalhelm@thestate.com.