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How Texas Cured Its Doctor Shortage and Became a Model for Healthcare Reform

PALM BEACH, Fla., Nov. 12 /PRNewswire-USNewswire/ -- America is facing a medical liability crisis which has resulted in decreased patient access to healthcare and rising health costs. The Pacific Research Institute (a not for profit, nonpartisan organization), was the first to do a detailed study quantifying the total cost of tort litigation in our country. They have calculated that the excessive tort costs in the United States due to lawsuit abuse totals $589 billion each year.

Lawsuit abuse by trial lawyers has been a major contributor to the increasing shortage of primary care physicians (internists, family doctor and pediatricians) and other high risk specialists (neurosurgeons, orthopedic surgeons, obstetricians and general surgeons.) There is no point in talking about increasing healthcare to the 47 million uninsured people or trying to providing "Universal Healthcare" until the doctor shortage problem is resolved first.

The state of Texas faced a similar problem six years ago and now serves as an example of how this problem can be solved. Texas has become a model for medical liability reform, but prior to the passage of medical liability reform, Texas presented a very difficult environment for doctors, hospitals and consumers of healthcare. Frivolous malpractice lawsuits were rampant and doctors were leaving the state in droves. Large numbers of patients whose doctors had left the state could not find replacements and were forced to seek care in emergency rooms. Physicians who remained found themselves overwhelmed trying to keep up with the demand for healthcare and considered joining those who had already left the state.

The numerous medical malpractice lawsuits caused the physicians who remained in Texas to practice "defensive medicine" ordering many more tests and procedures that they would not ordinarily have ordered to evaluate the patient's medical condition in order to protect themselves. Trial lawyers often tried to find one test or procedure the doctor did not order in an attempt to convince the medically unsophisticated jury that was the reason the patient had a problem to begin with.

No other country in the world permits trial lawyers to practice the way they do in the United States. These trial lawyers not only drive up the cost of health insurance, much of which was paid by business, but they also directly attacked businesses with similar frivolous lawsuits forcing businesses to flee Texas. The economy was depressed, many businesses closed and numerous people lost their jobs.

Though 85 percent of these frivolous lawsuits failed, doctors paid tens of thousands of dollars in unreimbursed expenses to defend themselves.

In 2003, the Texas Legislature passed medical liability reforms which were approved by voters who voted for the reforms in a constitutional amendment.

The reforms capped medical malpractice noneconomic jury awards at $750,000 ($250,000 for doctors, $250,000 for the first hospital and $250,000 for other health-care facilities), on lawsuit judgments for non-economic damages, such as pain and suffering. There is no cap on actual damages, such as medical bills or lost income. For death related case, economic damages were capped at $1.6 million. The reforms created stricter requirements for expert testimony and a tougher negligence standard for emergency medical cases.

The results after medical liability reform were spectacular as physicians by the thousand voted with their feet coming to Texas from the states that had not enacted tort reform. At one point there were so many doctors applying to Texas Medical Licensing Authority that they had a six month backlog in processing applications. Insurance costs have continued to come down over the past 5 years and the state had a financial boom with thousands of new high paying jobs being created. Texas has proven that medical liability reform works.

Click on to read the full article by Norman Traverse, M.D. Editor and to see a video produced by the Texans for Lawsuit Reform which shows what happened before and after reforms.

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