The multiplier method: scaling off your damages
The multiplier method is the industry's default approach. It takes your economic damages — medical bills and lost wages — and multiplies that total by a factor generally between 1.5 and 5, chosen based on injury severity, recovery time, and whether any permanent impairment is involved.
The per diem method: valuing each day
The per diem (Latin for "per day") method works differently. It assigns a specific dollar value to a single day of pain and suffering and multiplies that rate by the total number of days of documented recovery, tying the value directly to time rather than to the size of your medical bills.
A genuinely Massachusetts-specific wrinkle: it's not about severity at all
For an ordinary Massachusetts injury case, neither method runs into a cap at all. Medical malpractice is different — but the real decisive factor often isn't how badly the patient was hurt. If the defendant is a charitable organization, which covers most Massachusetts nonprofit hospitals, its total tort liability is capped at just $20,000 under G.L. c. 231, § 85K — a figure that applies regardless of injury severity and overrides the usual $500,000 medical malpractice cap entirely.
So identifying the defendant matters more than the method
Before investing effort in choosing between the multiplier and per diem methods for a Massachusetts malpractice claim, it's worth establishing whether the defendant qualifies as a charitable organization under § 85K, and whether the specific activity giving rise to the claim was charitable rather than commercial in nature. That single determination can matter more to the final number than either valuation method.
Neither is required by Massachusetts law
Both methods remain negotiating tools, not a formula Massachusetts courts are required to apply. A jury retains discretion to award whatever amount it finds appropriate for pain and suffering — subject to whichever cap, if any, genuinely applies to the case.