Court rules Obama recess appointments unconstitutional

WASHINGTON — A federal appeals court, dealing a defeat to President Obama, has sharply limited the chief executive’s power to bypass the Senate and to make temporary “recess” appointments to fill vacant slots in government agencies.

The Court of Appeals for the D.C. Circuit, in a 3-0 ruling,  said the president can make recess appointments only when the Senate has formally adjourned between sessions of Congress, not when lawmakers leave Washington for a brief break.

The Obama administration is almost certain to appeal the decision to the Supreme Court. But if the ruling stands, it strengthens the power of the Senate’s Republican minority at the expense of Obama and the Democrats.

PHOTOS: President Obama’s second inauguration

During his first term, Senate Republicans, led by Minority Leader Mitch McConnell (R-Ky), refused to approve Obama’s nominees for several agencies, including the National Labor Relations Board and the new Consumer Financial Protection Agency created in the wake of the Wall Street collapse of 2008. McConnell could rely on the filibuster rule by which the minority can block a vote by the majority.

In response, Obama invoked his power under the Constitution “to fill up all vacancies that may happen during the recess of the Senate.” Obama used this authority last January to appoint several new members to the National Labor Relations Board, ensuring the group had the necessary three members to make decisions. In addition to the NLRB appointments, Obama also installed Richard Cordray as director of the Consumer Financial Protection Bureau at the same time.

Business groups and Senate Republicans challenged the move, arguing the Senate was not truly in recess last January when it was out of session for several days.

In Friday’s decision, Chief Judge David Sentelle ruled for the challengers and said a “recess” refers to the break when Congress formally adjourns after a two-year session.

“An interpretation of 'the Recess' that permits the President to decide when the Senate is in recess would demolish the checks and balances inherent in the advice-and-consent requirement, giving the President free rein to appoint his desired nominees at any time he pleases, whether that time be a weekend, lunch, or even when the Senate is in session and he is merely displeased with its inaction. This cannot be the law,” said Sentelle, an appointee of President Reagan. He was joined by Judges Karen Henderson and Thomas Griffith, who are also Republican appointees.

PHOTOS: President Obama’s past

Cordray’s appointment is being challenged in U.S. District Court in Washington, D.C., in a separate lawsuit by a Texas bank and two free-market advocacy groups. They also claim the appointment was unconstitutional because the Senate was not in a formal recess. The suit is pending.

On Thursday, Obama renominated Cordray to the five-year term as director of the 2-year-old agency. Cordray’s recess appointment expires at the end of the year.

Obama said Thursday that Cordray was qualified for the position, but “he wasn’t allowed an up or down vote in the Senate, and as a consequence, I took action to appoint him on my own.”

Staff writer Jim Puzzanghera contributed to this report.

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david.savage@latimes.com

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Smartphone Sorcery: The Best Fantasy RPGs for Mobiles

Get your spell-caster on, explore castles, and lop off heads. Lop off lots of heads.

Battle for Wesnoth

Position your elven archers so they can take down orcs on horseback. Send scouts across the river and behind enemy lines. You’ve got to fight if you’re going to rule the land of Wesnoth. If you’re new to the moving-pieces-around-a-map strategy genre, this isn’t the place to start. Our army was wiped out during the tutorial.

WIRED Complex gameplay will keep you coming back for months.

TIRED Learning curve is more of a vertical line.

$3.99 iOS | $3.99 Android | Battle for Wesnoth

Final Fantasy 3

Previous mobile ports of classic Final Fantasy games have been pretty uneven. (The iOS version of the original is downright brutal.) But this 3-D remake feels great. You can tap anywhere on the screen to advance the turn-based battles, meaning you can plow through them as easily as if you were holding a controller. And for a touchscreen game that lasts 40 hours, comfort is key.

WIRED Simple, natural controls. Amazing orchestral soundtrack.

TIRED Graphics pulled from Nintendo DS are a waste of a retina display.

$16.99 iOS (iPad) $15.99 (iPhone, iPod) | $15.99 Android | Final Fantasy III

Zenonia 4

You won’t understand what’s going on with the swords-and-sorcery story line if you jump right into the fourth iteration of this action RPG (it involves time travel and your future self), but who cares when slashing up monsters and going on quests is this much fun? It’s free to play, which means you can spend real-life cash to buy upgrades like powerful helmets and pickaxes without having to grind.

WIRED Vibrant graphics. Satisfying thwack when you strike enemies.

TIRED Only one control option.

Free iOS | Free Android | Zenonia 4

Chrono Trigger

This time-traveling, dimension-hopping romp is one of the most beloved RPG adventures of the classic console era. But it doesn’t quite make the leap to mobile unscathed. The controls are imprecise at best, and the graphics, ported over from the Super Nintendo, look blurry instead of pixel-crisp. Still, it’s a fantastic game with wonderful writing and music.

WIRED A polished, thrilling, classic RPG for your phone.

TIRED Lackluster port job. Messy control scheme.

$9.99 iOS | Chrono Trigger

Mage Gauntlet

This action role-player features 16-bit-styled pixel artwork that makes it look like a long-lost vintage game. You’re an apprentice magician looking to pick up the tools of the trade while taking down bad guys, and you can alternate hacking and slashing with magic spells that you find along the way. It’s generally difficult to control characters using touchscreens, but Mage Gauntlet’s scheme is nearly perfect.

WIRED Old-school charisma. Satisfying hack-and-slashery. Funny dialog.

TIRED Enemy designs aren’t as appealing.

$2.99 iOS | Mage Gauntlet

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Booker winner Mantel says play next “logical step”

LONDON (Reuters) – Double Booker prize-winning author Hilary Mantel said the characters in her historical novels about the rise of Thomas Cromwell will take the next “logical step” to a stage adaptation at the Royal Shakespeare Company (RSC) this year.

Mantel said in a video interview on the RSC website this week that she has always longed to give “solid form” to her depictions of Cromwell, Henry VIII and Anne Boleyn in her “Wolf Hall” and “Bring Up the Bodies” books.

“From the moment I started writing Wolf Hall the characters were fighting to be off the page,” Mantel said in the video.

The 60-year-old Mantel said she was delighted to have playwright Mike Poulton, whose works have garnered some of the theatre world’s top awards, recreate her novels for the stage.

“He’s the man who knows about the stagecraft,” she said. “I’m the one who knows the characters inside out.”

The first woman and first Briton to win the Booker twice for her novels set in Henry VIII’s court said she has been inspired by the RSC since the age of 15 when she went alone to its Stratford-upon-Avon home and watched four plays in three days.

“It was a shaping experience, so it really is a dream come true for me to have the opportunity to see the RSC present my plays,” she said.

Mantel is working on a third novel in the trilogy.

The RSC also said on Wednesday that David Tennant will star in the title role of “Richard II” in winter 2013, making his return five years after a turn as Hamlet which earned him a best Shakespearean performance trophy at the Critics’ Circle Theatre Awards in 2009.

“Both plays will be directed by Royal Court Associate Director Jeremy Herrin, making his RSC directing debut,” RSC Artistic Director Gregory Doran said.

The world premiere of “Wendy & Peter Pan” by Ella Hickson and directed by Jonathan Munby will round out the winter season, the RSC said.

Tickets for the RSC’s winter 2013 season, which begins in October 2013 and runs until March 2014 will go on sale for members on February 11 and for the wider public on March 18, the RSC said.

(Reporting by Paul Casciato; editing by Patricia Reaney)

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Living With Cancer: The Good Patient Syndrome

I remember when being good seemed strategic.

After the technician took out a pad to draw an inscrutable diagram, I nodded and pretended to recognize a squiggle at the center of what looked like a snail. I discussed my oncologist’s research projects, instead of complaining about pain. Generally I answered a nurse’s opening query — “So how are you?”– with a cheery “Good! How are you?” Grumbles about waiting interminably for a scan in a freezing room never rolled off my tongue. When an interventional radiologist managed to remove two stents from my body, I didn’t fault the surgeon who left them there to trigger a massive infection followed by an allergic response to antibiotics: I sent a thank you note to the radiologist.

What was wrong with me? Outside the medical sphere, I am prone to impatience, candor and bouts of argumentative fervor. Had feminine socialization kicked in? As a girl, I was trained to be courteous to people in positions of authority and to revere the saving knowledge of physicians. But men also exhibit symptoms of the good patient syndrome.

Indeed, Anatole Broyard preached its virtues in his book “Intoxicated by My Illness,” although his version was less compliant, more ironic than mine. “If a patient expects a doctor to be interested in him, he ought to try to be interesting. When he shows nothing but a greediness for care, nothing but the coarser forms of anxiety, it’s only natural for the doctor to feel an aversion.” Following this logic, Broyard embarked upon an impersonation: “I never act sick. A puling person is not appealing.” He therefore set out to charm his physicians — to distinguish himself from boring, easily forgotten patients. I did this too, adding a pinch of obedience, a dash of gratitude, and a smidgen of eccentricity to the mix. One doesn’t want to be just any old patient; patients are replaceable.

Since illness had never intoxicated me, why was I behaving like Broyard? The short answer is terror: these people could hurt me.

Were I to seem boring or easily forgotten, should I appear crabby or disagreeable, I might get neglected or, in my anxious imagination, harmed. Not consciously neglected or intentionally harmed, of course, because doctors and nurses have dedicated themselves to helping people whose sickness often makes them boring and disagreeable. But neglected or harmed nonetheless. Like most patients, I am keenly aware that the medical staff at most facilities are overloaded. It is easy to get left for hours unattended on a gurney or starved and freaked when surgeries are perpetually postponed or distressed and bruised when the bindings on limbs are roughly or hastily applied.

But of course adopting the role of model patient does not provide a solution. Much of the caretaking in hospitals remains out of the control of our personal physicians and nurses. And in any case, too much ingratiating docility can be dangerous to a patient’s health.

If I had persisted in asking my surgeon about the fate of the stents that he had implanted in my body, he might have remembered to remove them. If I had not followed to the letter the dosage he prescribed of a heavy-duty antibiotic, especially as I began to get sick to my stomach and dizzy, I might not have had the full-body breakdown of an allergic reaction. Earlier still, if I had insisted on better bowel preps before my first abdominal surgery, or a postponement, maybe the stents and infection and the allergic reaction to antibiotics would never have happened.

Even before that, if I had challenged my general practitioner who diagnosed indigestion, maybe my cancer would have been found at an earlier stage. If my grandmother had wheels, she’d be an omnibus: that’s a family joke.

So much for the magical thinking that good patients receive the best care. Being a submissive or dutiful patient doesn’t always pay off. Who exactly was I being good for? Sometimes it’s good to be bad.

Was I good for nothing? When I was at my most puling and unappealing and too sick to be good, with pain so overwhelming that I had to be taken to my oncologist’s examining room in a wheelchair, she placed her hand on my knee and kept it there while explaining how she would take care of me. Though I could not look her in the eye, though I could not speak for groaning, I took her point. I had foisted the good patient role on myself. She had always seen through the pose to the mortally sick human being. Why else would I be here, I realized.

At that moment I resolved to renounce or rectify my goodness. I don’t always succeed.

---

Susan Gubar is a distinguished emerita professor of English at Indiana University and the author of “Memoir of a Debulked Woman,” which explores her experience with ovarian cancer.

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Wealth Matters: What the Small Player Can Expect When Using a Lobbyist

Robert Caplin for The New York Times

Domenic Rom, a senior vice president at Technicolor, a postproduction company for film and television, became part of a group of similar companies that wanted to lobby for a tax credit.

IF there is one thing most small-business owners have in common, it is that they have far less ability than big corporations to affect what happens to them politically.

Few small-business owners — the kind of people who accumulate wealth through a service or manufacturing business and are working at it every day — have the deep pockets of a major corporation. Consider what Amgen, the world’s largest biotechnology company, did to help win an exemption in the so-called fiscal cliff bill to extend its patent on a profitable dialysis drug for two more years at a great cost to Medicare. It sent its 74 lobbyists in Washington to meet with — and direct contributions to — a host of politicians who worked in its favor.

But even if small businesses can’t buy the kind of influence that a huge company like Amgen can, that does not mean they cannot buy influence at all. Still, as in other aspects of life, you get what you pay for.

Entrepreneurs would want to hire a lobbyist for a fairly straightforward reason: they have an issue they want addressed or changed and they have reached the point where they feel they need to act. What is more difficult is acting on that impulse effectively, knowing it could cost a lot of money.

Lawrence E. Scherer, a founder of State and Broadway, a lobbying firm in New York, said a typical retainer for a small-business client would be around $5,000 a month, but the assignment could last for a year or more. Suri Kasirer, once an aide to former Gov. Mario Cuomo of New York and president of Kasirer Consulting, said her typical retainer was $10,000 to $20,000 a month, with a three-month minimum.

“For small-business owners, the idea of having a lobbyist interact with a government is so novel and so out of their scope that $5,000 a month could seem daunting,” Mr. Scherer said. “But as government has more issues in front of it, it could be a cheap date.”

People who have success lobbying state and local governments — since the federal government is beyond the budget of individuals — tend to fall into three categories: they want something changed, they want something new or they want access.

Avik Kabessa, chief executive of Carmel Car and Limousine Service in New York City, said he became part of a group of livery car owners in 2008 that lobbied the state to establish a workers’ compensation fund for livery drivers and to repeal a sales tax on livery fares.

He said it took a year and a half for the lobbying efforts to work. The costs were split among members of the group, called the Livery Round Table. (Livery companies fall between higher-end black car and limousine services and city taxis.)

“I wish we had the expertise, knowledge and contacts to have been able to do this ourselves,” he said. “But just as you would go to a doctor when you’re sick, you go to a lobbyist for your legislative affairs.”

Ms. Kasirer is working on a similar case with a group of small-business owners who do not often work well together. She is representing seven expediters — companies that are paid by contractors and developers to handle getting various building permits in New York City. She said new rules could end their business.

“We were approached by a few of them, and we said ‘Let’s get as many of them together as we could,’ ” she said. “They realized that ultimately they could be put out of business or their business could be so severely handicapped that they would have to lay off people.”

For small-business owners, forming an ad hoc group and putting aside any competitive business interest to get something greater for their industry is important. So, too, is having the patience and the willingness to accept something short of their goal and then go back for more.

Domenic Rom, a senior vice president at Technicolor, a postproduction company for film and television, became part of a group of similar companies that wanted to lobby for a tax credit. While New York offered tax credits for shooting a film or television show in the state, it did not offer similar credits to the postproduction part of the industry, which includes editing, sound design and adding computer-generated effects.

Mr. Rom said the 14 companies created the Post New York Alliance and each paid $5,000 in dues. They began lobbying in 2009, working with Mr. Scherer. By the next year, they received a 10 percent tax credit for postproduction work.

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Principal ignored earlier report of abuse by teacher, Deasy says

The principal of a Wilmington elementary school received an allegation about four years ago that a teacher behaved inappropriately with a student but took no action, Los Angeles Unified School District Supt. John Deasy said Thursday.

The same teacher was arrested Wednesday on suspicion of committing lewd acts and sexually abusing 20 children and an adult, law enforcement authorities said.

Deasy said he removed the principal from her job after learning last March that she hadn't acted on the earlier allegation. “When I reviewed the personnel file of the teacher,” said Deasy. “It came to my attention that several years earlier, in about 2008, there was an allegation that was not properly reported. That was enough for me” to remove the principal.

Deasy added that the teacher’s file “contained notations of suspected misconduct along the lines of what he was later charged with, which was inappropriate touching of a student. I don’t know the specific nature of the touching.”

Robert Pimentel, 57, who taught at George de la Torre Jr. Elementary School in Wilmington, was taken into custody by Los Angeles Police Department detectives, who had launched an investigation in March after several fourth-grade girls said they had been inappropriately touched.

Prosecutors filed 15 charges against Pimentel involving a dozen alleged victims. The charges allege sexual abuse and lewd acts on a child and cover the period from September 2011 to March 2012, according to court records. Authorities said the teacher is suspected of inappropriately touching children under and over their clothing.

Detectives suspect Pimentel victimized an additional eight children and the adult, LAPD Capt. Fabian Lizarraga told The Times.

The nation's second-largest school district has been rocked in the last year by allegations of sexual misconduct involving teachers and students.

In January 2012, a teacher at Miramonte Elementary School in the Florence-Firestone neighborhood was arrested on suspicion of spoon-feeding semen to students in a classroom and taking dozens of photos. Some of the photos show students blindfolded and being fed allegedly tainted cookies.

An audit released in November concluded that the district failed to promptly report 150 cases of suspected teacher misconduct — including allegations of sexual contact with students — to state authorities as required by law. District officials say they have addressed breakdowns highlighted in the audit.

Parents of children at the Wilmington school were informed within 72 hours after Pimentel was removed from the campus, and the California Commission on Teacher Credentialing was promptly notified, the district said.

District officials prepared a "notice of termination" for Pimentel and the principal, which they had planned to present to the Board of Education in April 2012, Deasy said. But both employees retired before the board meeting.

He said Pimentel and the principal will receive their full pensions because they retired before the district took action against them.

"Can you go back and fire someone who's already retired? No, you can't," Deasy said.

Detectives launched their investigation of Pimentel after some of the children told their parents they had been abused, Lizarraga said. The parents then alerted officers at the LAPD's Harbor Division.

Of the 20 children allegedly abused, 19 were students at the school, according to Lizarraga. He said detectives came across the other child as they gathered evidence.

Deasy told The Times that his recollection was that the adult was a co-worker of Pimentel.

Pimentel, who lives in Newport Beach, had been a teacher with the district since 1974, police said. He was taken into custody shortly after noon Wednesday and was being held on $12-million bail. He is expected to appear in court Thursday.

In the Miramonte Elementary case, former teacher Mark Berndt, 62, is charged with 23 counts of lewd conduct and is awaiting trial. He has pleaded not guilty.

In a separate case, a jury recently awarded $6.9 million to a 14-year-old boy who was molested while he was in fifth grade at Queen Anne Place Elementary School in the Mid-Wilshire area.

The teacher in that incident pleaded no contest to two counts of a lewd act on a child and to continuous sexual abuse of a child younger than 14. He is serving a 16-year prison sentence.

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Lookin' Hot in the Cold: Technical Outerwear for Winter

Winter outerwear has come a long way from the clammy straight-jackets your mom would wrap around you every time you wanted to go outside.

Every year, we see jackets, shells, bibs and pants that are more breathable, lighter, stretchier, and just plain better-looking than last year's crop.

We sifted through the countless options on the racks and selected a dozen or so favorite items, then took the whole pile of gear with us to Squaw Valley in California's Lake Tahoe region. We worked them over on the slopes for three days, then took the lot deeper into to the Sierras for another week. We also tried to pick something for everyone -- from Gore-Tex jeans (pre-distressed!) to a snow shell that costs as much as a mortgage payment, and even a down jacket hand-stuffed by followers of a 16th-century pacifist. It's going to be a weird, Wired winter.

The Phenomenon jacket from Spyder is pretty much what would happen if you said, "Screw the cost, let's make a jacket with the best materials we can find." The list of what went into the $1,200 garment looks like the textile version of the Robb Report.

The waterproof membrane is made of Schoeller c-change, which opens its pores to vent heat and moisture when the interior warms up. Custom-embossed stretch polyester lines the interior. Primaloft One insulation lines the body and sleeves. And the outer shell is composed of DWR-treated stretch polyester material with wool accents. Premium!

It was warm, waterproof and comfortable on the slopes, with no movement restricted, plenty of waterproof zip pockets and ventilation, and so many features, I actually lost track of everything that was special about it while I was showing it off to people. To top it all off, the jacket looks like money -- the slim cut and wool accents made it fit right in over a suit and tie on the way to office Christmas parties. -- Billy Brown

WIRED Fantastic material choices all around. Tough waterproof outer with great stretch. Removable hood and snow skirt. Gusseted cuffs are adjustable. Plays dress-up better than Eliza Doolittle.

TIRED I've owned cheaper cars.

Rating: 9 out of 10

Photos by Ariel Zambelich/Wired

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Aretha Franklin Approves of Beyonce’s ‘Beautiful’ Inaugural Lip-Syncing

LOS ANGELES (TheWrap.com) – Aretha Franklin r-e-s-p-e-c-t’s Beyoncé’s decision to use a “beautiful” pre-recorded rendition of the national anthem during President Barack Obama‘s inaugural ceremony on Monday.

The Queen of Soul, who sang “My Country ‘Tis of Thee” during Obama‘s inauguration in 2009, told ABC News that the cold weather warranted Beyoncé lip-syncing “The Star-Spangled Banner.”

“The weather down there was about 46 or 44 degrees and for most singers that is just not good singing weather,” Franklin said after noting the news gave her a good laugh. “When I heard that I just really cracked up. I thought it was really funny, but she did a beautiful job with the pre-record … next time I’ll probably do the same.”

She says “next time,” because she wasn’t afraid to brave below-freezing temperatures in Washington D.C. when she performed live four years ago. “In 2009, I wanted everything to be live and on the real side for the moment as it actually happened. Those were my feelings for my performance, but having come face to face with 28, 22 degrees I am not surprised she pre-recorded,” Franklin continued. “She wanted her performance to be what she wanted to be and she realized it wasn’t going to be the way she wanted it to be or she was going to be running a risk. That’s probably why she pre-recorded exactly how she wanted it to be heard.”

The 70-year-old Franklin isn’t the only music star shrugging off Beyoncégate. Jennifer Lopeztold Jon Stewart on Tuesday’s episode of “The Daily Show” that “all performers do have to” lip-sync at some point in their career.

“You know, sometimes it happens,” she explained. “When you’re in certain stadiums and in certain venues, they do pre-record things.”

Lopez’s former “American Idol” judging panel partner, Steven Tyler, isn’t particularly bothered by Beyoncé lip-syncing either. “It doesn’t matter,” he told TMZ.

“Beyoncé’s so hot, she can do anything,” the Aerosmith frontman added to give some shallow perspective. “Let’s just get real.”

Whether or not Beyoncé would agree with Tyler’s flattering statement, she has yet to comment on the matter herself, aside from posting the performance on her Tumblr — an action that suggests she has no regrets.

Meanwhile, the U.S. Marine Band that previously admitted to using a pre-recorded track to back her performance and suggested Beyoncé did the same for her vocals, has changed its tune.

“Each piece of music scheduled for performance in the Inauguration is pre-recorded for use in case of freezing temperatures, equipment failure, or extenuating circumstances,” a spokesman for the Marines told TheWrap on Tuesday. “Regarding Ms. Knowles-Carter’s vocal performance, no one in the Marine Band is in a position to assess whether it was live or pre-recorded.”

Music News Headlines – Yahoo! News

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Well: The Drawn Out Process of the Medical Lawsuit

She was one of the most highly sought radiologists in her hospital, a doctor with the uncanny ability to divine the source of maladies from the shadows of black and white X-ray films.

But one afternoon my colleague revealed that she had been named in a lawsuit, accused of overlooking an irregularity on a scan several years earlier. The patient suing believed she had missed the first sign of a now rampant cancer.

While other radiologists tried to assure her that the “irregularity” was well within what might be considered normal, my colleague became consumed by the what-if’s. What if she had lingered longer on the fateful film? What if she had doubled-checked her reading before signing off on the report?

She began staying late at the hospital to review, and re-review, her work. And she worried about her professional reputation, asking herself if colleagues were avoiding her and wondering if she would have trouble renewing her license or hospital privileges. At home she felt distracted, and her husband complained that she had become easy to anger.

After almost a year of worry, my colleague went to court and was cleared of the charges. But it was, at best, a Pyrrhic victory. “I lost year of my life,” she told me. “That lawsuit completely consumed me.”

She was not the first colleague to recount such an experience. And far from overstating the issue, doctors may in fact be underestimating the extent to which malpractice not only consumes their time but also undermines their ability to care for patients, according to a new study in Health Affairs.

For more than 150 years, the medical malpractice system has loomed over health care, and doctors, the vast majority of whom will face a lawsuit sometime in their professional lives, remain ever vocal in their criticism of the system. But with few malpractice claims resulting in payments and liability premiums holding steady or even declining, doctors have started to shift their focus from the financial aspects of malpractice to the untold hours spent focused on lawsuits instead of patient care.

Now researchers are putting numbers to those doctors’ assertions. For the current study, they combed through the malpractice claims records of more than 40,000 doctors covered by a national liability insurer. They took note of the length of each claim, as well as any payments made, the severity of the injury and the specialty practiced by the physician being sued.

Most claims required almost two years from initiation of the lawsuit, and almost four years from the time of the event in question, to reach a resolution. Cases that resulted in payment or that involved more severe patient injuries almost always took longer.

The researchers then looked at the proportion of a doctor’s career spent on an open claim. They discovered that on average, doctors spent more than four years of their career — more time than they spent in medical school — working through one or more lawsuits. Certain specialists were more vulnerable than others. Neurosurgeons, for example, averaged well over 10 years, or over a quarter of their professional life, embroiled in lawsuits.

“These findings help to show why doctors care so intensely about malpractice and what they might face over the course of a lifetime,” said Seth A. Seabury, lead author and a senior economist at the RAND corporation in Santa Monica, Calif.

The results also underscore what plaintiffs must endure. Previous studies have shown that when medical errors occur, patients prefer to have physicians acknowledge the mistake quickly and apologize as soon as possible. Though less than 5 percent of all errors ever lead to a malpractice claim, lengthy claims drag out the process and, in certain cases, hold up what may be appropriate compensation.

Patients not directly involved can be affected as well. A legitimate malpractice lawsuit sometimes results in doctors or even entire institutions changing how they practice in order to prevent similar events from happening again. Lengthy legal wrangling can slow down these potentially important improvements.

While these findings are only an indirect measure of the extent to which malpractice claims can affect doctors’ and patients’ lives, the study makes clear the importance of considering time, as well as cost, when looking at malpractice reform.

“If we could get these cases resolved faster, we might be able to improve the efficiency of the system, lower costs and even improve quality of care for patients,” Dr. Seabury said.

“Having these things drag on is a problem for doctors and patients.”

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DealBook: Choice for S.E.C. Is Ex-Prosecutor, in Signal to Wall St.

President Obama is tapping Mary Jo White, a former United States attorney turned white-collar defense lawyer, to be the next chairwoman of the Securities and Exchange Commission, according to the White House.

Mr. Obama is set to announce the nomination at the White House on Thursday afternoon. As part of the event, the White House will also renominate Richard Cordray to lead the Consumer Financial Protection Bureau, a role he has held for the last year under a recess appointment.

In its choice of Ms. White and Mr. Cordray, the White House is sending a signal about the importance of holding Wall Street accountable for wrongdoing. Both picks are former prosecutors.

Regulatory chiefs are often market experts or academics. But Ms. White spent nearly a decade as United States attorney in New York, the first woman named to this post. Among her prominent cases, she oversaw the prosecution of the mafia boss John Gotti as well as the people responsible for the 1993 World Trade Center bombing. She is now working the other side, defending Wall Street firms and executives as a partner at Debevoise & Plimpton.

As the attorney general of Ohio, Mr. Cordray made a name for himself suing Wall Street companies in the wake of the financial crisis. He undertook a series of prominent lawsuits against big names in the finance world, including Bank of America and the American International Group.

The White House expects Ms. White, 65, and Mr. Cordray, 53, to draw on their prosecutorial backgrounds while carrying out a broad regulatory agenda under the Dodd-Frank Act. Congress enacted the law, which mandates a regulatory overhaul, in response to the 2008 financial crisis.

Jay Carney, the White House press secretary, said Ms. White has “an incredibly impressive resume” and that her appointment along with the renomination of Mr. Cordray sends an important signal.

“The president believes that appointment and the renomination he’s making today demonstrate the commitment he has to carrying out Wall Street reform, making sure we have the rules of the road that are necessary and that are being enforced in a way” to avoid a crisis like that of 2008, Mr. Carney said.

Another White House official added that Ms. White and Mr. Cordray will “serve in top enforcement roles” in part so that “Wall Street is held accountable and middle-class Americans never again are harmed by the abuses of a few.”

Ms. White will succeed Elisse B. Walter, a longtime S.E.C. official, who took over as chairwoman after Mary L. Schapiro stepped down as the agency’s leader in December. Mr. Cordray joined the consumer bureau in 2011 as its enforcement director.

The nominations could face a mixed reception in Congress. The Senate already declined to confirm Mr. Cordray, with Republicans vowing to block any candidate for the consumer bureau, a new agency created to rein in the financial industry’s excesses. It is unclear whether the White House and Mr. Cordray will face another standoff the second time around.

Mr. Carney argued that there were no substantive objections to Mr. Cordray’s confirmation, only political ones. “He is absolutely the right person for the job,” Mr. Carney said.

Ms. White is expected to receive broader support on Capitol Hill. Senator Charles E. Schumer, a New York Democrat, declared that Ms. White was a “tough-as-nails prosecutor” who “will not shy away from enforcing the laws to ensure that markets operate fairly.”

But she could face questions about her command of arcane financial minutiae. She was a director of the Nasdaq stock market, but has otherwise built her career on the law-and-order side of the securities industry.

People close to the S.E.C. note, however, that her husband, John W. White, is a veteran of the agency. From 2006 through 2008, he was head of the S.E.C.’s division of corporation finance, which oversees public companies’ disclosures and reporting.

Some Democrats also might question her path through the revolving door, in and out of government. While seen as a strong enforcer as a United States attorney, she went on in private practice to defend some of Wall Street’s biggest names, including Kenneth D. Lewis, a former head of Bank of America. She also represented JPMorgan Chase and the board of Morgan Stanley. Last year, the N.F.L. hired her to investigate allegations that the New Orleans Saints carried out a bounty system for hurting opponents.

Consumer advocates generally praised her appointment on Thursday. “Mary Jo White was a tough, smart, no-nonsense, broadly experienced and highly accomplished prosecutor,” said Dennis Kelleher, head of Better Markets, the nonprofit advocacy group. “She knew who the bad guys were, went after them and put them in prison when they broke the law.”

The appointment comes after the departure of Ms. Schapiro, who announced she would step down from the S.E.C. in late 2012. In a four-year tenure, she overhauled the agency after it was blamed for missing the warning signs of the crisis.

Since her exit, Washington and Wall Street have been abuzz with speculation about the next S.E.C. chief. President Obama quickly named Ms. Walter, then a Democratic commissioner at the agency, but her appointment was seen as a short-term solution. It is unclear if she will shift back to the commissioner role if Ms. White is confirmed.

In the wake of Ms. Schapiro’s exit, several other contenders surfaced, including Sallie L. Krawcheck, a longtime Wall Street executive. Richard G. Ketchum, chairman and chief executive of the Financial Industry Regulatory Authority, Wall Street’s internal policing organization, was also briefly mentioned as a long-shot contender.

Peter Baker and Kitty Bennett contributed reporting

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