COLUMBIA, S.C. - The medical community needs to scrutinize more of its doctors who make mistakes, some lawmakers say.

The issue has been debated as lawmakers approved a bill that would set a $1 million cap per victim on jury awards in medical malpractice cases. That measure needs final approval by the House next week before heading to the governor's desk.

Sen. Brad Hutto, D-Orangeburg, said doctors groups have lobbied for the cap, but they haven't shown the same enthusiasm for tougher licensing and discipline standards.

"They want us to protect them by giving them caps," said Hutto, who is active in the medical malpractice debate in the Senate and the husband of a pediatrician. "But the other side of that coin is they must be better able to police themselves."

House Judiciary Committee Chairman Jim Harrison, R-Columbia, asked during a committee hearing on the medical malpractice bill what doctors were doing to improve their profession from within.

"I didn't get much of an answer," the Columbia lawyer said. "It sounds like there are some doctors ... who want relief (from lawsuits) but are blocking what would be better self-policing."

Doctors' organizations say the two issues should be viewed separately and that patient safety comes first.

"There is no correlation between the two," said Todd Atwater, director of the 6,700-member South Carolina Medical Association.

Rep. James Smith, D-Columbia, is skeptical doctors want more public scrutiny.

"If the number one concern of the physicians advocating tort reform is patient safety ... and not self-interest," Smith said of the malpractice bill, "then they will pursue as vigorously the policing of their profession. These are not mutually exclusive."

Earlier this month, the state Board of Medical Examiners approved the first major rewrite of regulations for how doctors are licensed and disciplined. One major change is it would allow the public to learn about complaints against doctors sooner.

Currently, all board disciplinary proceedings are secret until action is final. The proposed changes, which need legislative approval, include publicly disclosing interim and temporary suspensions.

In the past year, sanctions against two doctors have ignited a debate over which agency has the final say in discipline cases and which of those venues - if either - is open to the public.

"The direction of reform up here is to stop the process of going from the agency to the courts and then back to the agency," state Sen. Glenn McConnell, R-Charleston, said.

The medical board ordered West Columbia alternative medicine physician Dr. James Shortt to stop intravenous infusions after one of his patients died. The case went to an Administrative Law Court and remains unresolved a year after the patient, Katherine Bibeau, died.

Shortt has agreed to limit his practice while his case is argued. The board continues to list him as having no disciplinary violations.

Hilton Head Island cardiologist James Johnston, whom the board sanctioned three times because of alcohol impairment, blocked his discipline by appealing to the administrative court. A newspaper's lawsuit to open the records and settle the jurisdictional question was argued last week before the state Supreme Court.

Dr. William Hueston, president-elect of the 1,400-member state Academy of Family Physicians, said the proposed changes are improvements.

"If we're going to have licensing, we have to come down on the side of having a more open process," McConnell said. "I just think you instill more public confidence."

House Speaker David Wilkins said he would wait until the medical board's proposed changes were submitted as legislation.