Physicians in white coats filled most of the west lawn of the US Capitol on Wednesday afternoon, chanting for “tort reform” and carrying signs protesting Congress’s failure to pass legislation to address spiraling malpractice insurance premiums.

Meanwhile, directly across the street, a much smaller group of patients and relatives of patients who had been injured by the medical system charged that the physicians should be working to correct medical mistakes at home, not marching on Washington.

The competing signs carried by members of the two groups spoke volumes about the tone the debate over whether to cap damages in malpractice has taken on.

“Stop Jackpot Justice,” and “No Frivolous Lawsuits,” read the signs sported by the doctors. “We Are Not Frivolous,” and “It’s a Lovely Day for Golf,” responded those carried by the patients.

Republican Senator Rick Santorum of Pennsylvania, the lead sponsor of Senate legislation to impose a $250,000 cap on damages for “pain and suffering” in malpractice suits, told the physicians - who arrived in 60 buses from four east-coast states - that doctors who are quitting or moving to other states to escape high premiums “is a national problem and requires a national solution.”

But Santorum acknowledged that the Senate currently lacks the votes to pass his measure over the objections of most Democrats and a half dozen Republicans. “Most (senators’) minds are already made up on this issue,” said Santorum. “In the end, you have to make a difference not in April, but in November,” at the polls, he added.

Dr. Dennis McWeeney, a second-year ob-gyn resident at St. Barnabas Hospital in Livingston, New Jersey, said he came because he was concerned that if something is not done, medical students will simply not enter specialties like his where premiums are highest.

In his medical school class of 130, he said, “only seven chose ob-gyn, and now it’s down to three.”

But patients were scornful of the doctors’ complaints. “It’s an orgy of arrogance,” said Michael Bennett, whose 89-year-old father died in 2004 after a series of complications stemming from medical mistakes at five different hospitals.

Herman Cole of Bridgeport, Connecticut, whose wife was left in a coma at the hands of an anesthesiologist whose license had already been suspended in another state, said capping damages is not the answer to higher premiums. “That decision needs to be left in a jury’s hands or a judge’s,” he said.