“When we were finishing residency, we only looked at states that would provide us some semblance of protection from frivolous lawsuits. Having seen countless TV ads in North Carolina featuring lawyers actively recruiting patients who’d had less-than-optimal health care outcomes, we knew that we could never practice there,” Dr. Justin Hensley said. North Carolina’s loss was Texas’ gain. The husband-and-wife physi- cians selected Corpus Christi for their practice location in 2011. They say they made the right decision.
ate procedure based on a clinical diagnosis. In Texas, I get to practice medicine according to what’s right for the patient, not based on what keeps me from getting sued,” Dr. Katherine Hensley said. Sandra Williams, DO, an emergency physician at Houston’s
D
Ben Taub Hospital, attended medical school in Florida and also selected Texas because of its liability protections. “The attending physicians and faculty members in Florida had to call multiple hospitals to find a specialist to treat a pa- tient needing immediate medical attention. In Texas, special- ists aren’t afraid to take call, and I’m able to transfer patients to the care they need,” she said. These physicians are among tens of thousands who enjoy the positive effects of tort reform: a practice atmosphere in which patients benefit from improved access to physicians who can make appropriate care determinations based on the best interest of patients, and a legal atmosphere in which fewer lawyers seek jackpot justice. Ten years ago, TMA, the Texas Alliance For Patient Access
(TAPA), the Texas Medical Liability Trust (TMLT), the Texas Hospital Association (THA), physicians, and medical stu- dents banded together against personal injury trial lawyers and worked to pass landmark medical liability reforms. The Medical Malpractice and Tort Reform Act of 2003, House Bill 4, went into effect Sept. 1 that year. Twelve days later, Texas voters approved Proposition 12, an amendment to the Texas Constitution that validated the legislature’s actions. HB 4 caps noneconomic damages in health care liability cases. Texas’ $750,000 total cap includes a $250,000 limit on physician ex-
22 TEXAS MEDICINE September 2013
uring my residency training, a surgeon wouldn’t touch any kid who came in with appendicitis until the patient had undergone a CT scan. My experience in Texas has been that surgeons will proceed with the appropri-
posure for noneconomic damages such as pain and suffering. The tort reform act doesn’t restrict economic damages. TMA Executive Vice
President and Chief Ex- ecutive Officer Louis J. Goodman, PhD, says tremendous pressure mounted in the days leading up to passage of the tort reform act to agree to a noneconomic damages cap much high- er than $250,000. “TMA knew Gover-
nor Perry had promised the doctors a $250,000 cap, so we held firm and ultimately prevailed
when the bill was signed and voters passed the constitutional amendment several months later,” he said. Fortunately, thanks to the work of TMA, TAPA, medical spe- cialty societies, individual physicians, and other organizations, the state’s tort laws have remained intact for the past 10 years. Tort reform has been an immense boon to the state, says Dr. Justin Hensley. “Tort reform has done wonders for the state by attracting
more physicians to practice here, improving access to care, and making it economically possible for physicians to continue car- ing for patients,” he said.
Then vs. now Before tort reform, doctors were leaving or limiting their prac- tices because of soaring liability costs. According to TAPA Di- rector Jon Opelt, about 20 percent of the state’s physicians hadn’t been renewed by their insurance carriers and were in jeopardy of losing hospital privileges.
“Many doctors who still maintained liability coverage re- fused to accept patients with complex or high-risk problems, referring them to an increasingly shrinking pool of specialists. Emergency room services for head injuries, childbirth, and trauma involving small children were in shorter supply. All blamed the state’s hostile medical liability climate,” he said, citing results of TMA’s widely publicized 2003 surveys. In the run-up to reform, Mr. Opelt adds, 55 Texas counties
had a net loss of physicians, and another 50 failed to add a single physician. Some 99 counties lost a high-risk specialist, and an estimated 5,000 high-risk specialists restricted their practices because of liability concerns. Arlo Weltge, MD, clinical professor of emergency medicine at The University of Texas Medical School at Houston, says the difference in Texas’ medical liability environment since tort re- form was passed in 2003 is “night and day.” (See “Tort Reform
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