Where Have All the Doctors Gone?

[Dr. Steve Urkel]

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August 25,2003


Just how many doctors have Texans lost as a result of the medical malpractice insurance crisis? The definitive answer is now in and the answer is staggering. According to a newly released study by the US Department of Health and Human Services, the lack of caps on skyrocketing non-economic awards and medical negligence law suits has cost Texans 4,560 physicians. That is roughly 12% of the total number of physicians in the entire state.

In Tarrant County alone, the number lost totals a whopping 228 doctors, enough doctors to staff an entire children?s hospital the size of Fort Worth Cook?s Children Hospital plus a community hospital nearly the size of John Peter Smith (Tarrant County?s public hospital). If there was really any doubt about the devastating and insidious impact on access to medical care wrought by our current out of control medical liability system, these doubts are now gone.

The findings are the results of a landmark research study entitled ?The Impact of State Laws Limiting Malpractice Awards on the Geographic Distribution of Physicians? released by the Agency for Healthcare Research and Quality on July 3rd, 2003. Authors, Fred Hellinger, PhD and William Encinosa, PhD, analyzed the impact of caps on medical negligence awards in states with caps as compared to states without caps. The study took into account other factors known to effect geographic physician distribution ranging from local population age distribution, unemployment rate, degree of ?ruralness?, regional per capita income, even factors as detailed as average local daily temperature.

The study discovered states with caps had on average 12% more physicians per capita than states without caps. That figures out to 15 more doctors for every 100,000 citizens. This comes as no surprise to doctors in Texas who have witnessed a silent epidemic of doctors quietly restricting their practices to low risk patients, leaving the practice of medicine prematurely, or moving out-of-state.

For Texans, this is particularly bad news. Texas already ranks at the bottom of the pile when it comes to physician numbers. Presently, Texas has a mere 89 doctors per 100,000 population, placing us in a tie for the 48th worst state in terms of physician manpower. Only Missouri at 82 doctors per 100,000 population and Oklahoma at 73 doctors per 100,000 population are worse off. As so aptly stated by H.H.S. Secretary Tommy G. Thompson, ?Our broken medical liability system is affecting our patients? ability to find a doctor.? The scientific validity of these findings is not in dispute. Only those in denial or with a vested financial interest in the current status quo will claim otherwise.

The time for policy debate is over. The need for medical tort reform and caps on non-economic damages has clearly come. Following months of review and vigorous debate, the 78th Texas Legislature drew the same conclusion: Texans deserve to be better off than the bottom of the pile when it comes to affordable and accessible medical care.

Texans will have the opportunity to win back and secure their right of access to medical care. They can do so on September 13, 2003 by approving Proposition 12, a constitutional amendment authorizing the legislature to cap non-economic damages in medical negligence cases. The landmark study of Hellinger and Encinosa sends a clear message: The very health and lives of Texans hangs in the balance on September 13, 2003.

On this day, commonsense will prevail over the self-interest, the rantings and misinformation campaign touted by the well-moneyed plaintiff lawyers. Texans will proudly join the 23 other thriving states that have already wisely enacted caps. For their own sakes and for the sakes of their loved ones, Texans must vote to save their doctors on September 13, 2003.

John L. Durand, M.D.
Fort Worth Cardiologist
1300 West Terrell, Suite 500
Fort Worth, TX 76104
(pager 817.930.7525)






I have heard many of you say, "I hope this is all resolved by the time I begin to practice." People, People, People, this is our fight as well, plan for your future today. If you are a Texas resident vote FOR proposition 12.

 

[soonerpillow]

Originally posted by Dr. Steve Urkel

Only Missouri at 82 doctors per 100,000 population and Oklahoma at 73 doctors per 100,000 population are worse off.

Hey, look at that! we're in last place. I had no idea. All I can say is, OU better not reject my a$$, cuz we need more doctors!

 

[destined_wind]

Yeah, malpractice insurance is just crazy these days. Hmm, I live in California and here there IS a CAP on malpractice lawsuits. I think there should be a cap to how much a person would be compensated for damages as a result of medical mistakes. Then again, I have seen incidents in which the mistakes are SO horrendous (such as the Duke incident awhile back that made all the headlines) that just scream for a tremendous amount of monetary compensation.

 

[swampfox]

I think most people would agree that some form of cap on malpractice payouts is needed. However, people should be sure to distinquish between the compensation and the penalty of malpractice awards.

No one would argue that if a doctor is neglegent and harms a patient the doctor should be liable for expenses (medical, lost wages) that are incurred by the patient as a direct result of the neglegence.

What most of the malpractice legislation puts a cap on is the penalty that can be levied above and beyond the expenses defined above. This penalty is often referred to as the "Pain and Suffering" of the victim.

Most of the legislation, such as that in California, puts a dollar limit on the "Pain and Suffering" of a patient victim - $250,000 for example. Just as Desitined_Wind mentioned above, though, the $250,000 limit may not be a sufficient penalty if the malpractice was expecially bad. I think the penalty payment should be tied to the compensatory with a ratio - 3 to 1 sounds good to me. That way the penalty would move up or down with the severity of the malpractice as measured by the cost of the compensatory damage award.

Of course, there is some problem in the arrangement when death is a result of the malpractice. Putting a dollar value on a life is difficult, but economists do it all the time...

Just my $0.02

 

[steve007]

could anyone provide a link to this type of data by state? thanks

 

[dmoney41]

What's interesting is that I was reading some business magazine (Money?) at my mom's a few weeks ago and they said that in states where caps are implemented the insurance still doesn't go down much if at all - the insurance providers just skim more profits.

All the statistics in this article compare "physicians per capita", a statistic I think is tied (at best) very, very loosely to malpractice caps. I know I wouldn't choose the state to practice in based on what malpractice insurance cost.

The statistic I want to see is average % change in malpractice insurance cost one and two years after caps are implemented. I bet the change isn't quite as big as they'd like us to believe.

 

[Dr. Steve Urkel]

You're absolutely right, usually at this point the state has to come in and order them to lower their fee. But change does come.