Med-Mal Down, Doctor Shortage Up?

According to the Texas Medical Association, the 2003 tort reforms they pushed so hard for are paying off – for reals.

That's right, according to a September press release from the TMA (the largest state doctor's association), tort reform worked so well that that the Texas Medical Liability Trust – that's the not-for-profit medical malpractice insurer that insures more than 14,000 TMA affiliated docs – has again reduced its premiums and offered a 24% dividend to current policyholders. That's some scratch!

Enough scratch, it seems that the TMLT is among several groups that have organized for tonight (Thursday) a nice meet-and-greet schmooze fest at the Ferrari dealership on North Lamar. "Come as you are – bring your spouse, physician colleagues, and your business cards. Light refreshments served."

That's awesome. Just super duper. I mean, sure, it's great that docs and their insurers can again afford Ferraris (yeah, I know they're only schmoozing there, but, please: Do you think the Ferrari dealership opens its doors to, say, a public school teachers social? I think not) – especially considering the dire, dire predictions we were given back at the beginning of the decade about how doctors would be run out of business, and out of the state, because of high med-mal rates prompted by frivolous lawsuits.

And to hear Gov. Rick Perry tout the tort reform package in his 2007 State of the State speech, it was the courageous reforms pushed through by lawmakers – that is, a package of measures that limit the ability of individuals to avail themselves of the legal process and to sue in cases of medical negligence – that have lowered med-mal costs and helped to recruit doctors to the state.

Hmmm. That sounds super good, but is it true? Not at all, according to Texas Watch. For starters, the state still has the highest rate of uninsured residents, with nearly 25% of the population without any health insurance. And, moreover, according to the TMA, the state now ranks 42nd in the country for the number of doctors per capita; nearly half of all Texas counties do not meet the national standard for having 114 doctors per 3,500 people, according to Texas Watch.

Wait, what?

Yes, it is true, we're still short on doctors. But how can this be, you ask? I thought tort reform was supposed to take care of everything? Apparently you thought wrong. Indeed, according to Dr. Gary Floyd, the chief medical officer for Fort Worth's John Peter Smith Hospital, the real problem is that the state hasn't created enough residencies for all the doctors educated in the state, in part with taxpayer money. If there aren't enough residencies, he told the House Committee on County Affairs during a hearing held at the hospital, the doctors will go elsewhere to finish training and then will likely stay put in those places.

And you know why there aren't enough residencies? Frivolous lawsuits? No, no, we took care of those. The real problem, witnesses told the committee, is that Medicare and Medicaid funding caps have "forced" healthcare agencies to "freeze or scale back" residency programs, Floyd said. The TMA, reports the Fort Worth Star-Telegram, is expected to advocate during next year's Lege session for an expansion of the number of residencies in the state.

In other words, it appears now that tort reform wasn't exactly the panacea we were led to believe. And it certainly didn't create a rush of doctors flocking to, or staying in the state as we were led to believe it would.

Well, crap. At least we still have the Ferraris.