A development not confined to the medical litigation sphere of course, but many have noted the reduction in the number of disputes requiring a trial for finalisation of the dispute. AIHW data from 2010-2011 suggests only 3% of medical indemnity claims finalise through a court decision.
An article by John Langbein in the Yale Law Journal entitled The Disappearance of the Civil Trial in the United States provides a thoughtful analysis on the reasons why. Many of those reasons appear equally relevant to Australia.
As the author concludes quoting Emerson, build a better mousetrap and the world will beat a path to your door. Pre-hearing processes appear to provide that better mousetrap.