Sunday, August 21, 2011

Medical Malpractice Is about Physician Jobs

Nearly 31% of the new Texas jobs are in health care, many of which are no doubt the product of federal entitlements that go to every state. But the state is also making progress filling in historical access gaps in west and south Texas and the panhandle, where Mr. Perry's 2003 malpractice caps have led to an influx of doctors, especially high-risk specialists. The Texas Public Policy Foundation estimates that the state has netted 26,000 new physicians in the wake of reform, most from out of state.

Review & Outlook, “The Texas Job Panic,” Wall Street Journal, August 11, 2100

August 21, 2011 - The job outlook for physicians differs from that of the general population. Because physicians are in short supply, they have no problem finding jobs, high paying ones at that, when you compare their incomes to the rest of society. There are more available jobs than physicians.

This inverse job situation becomes critical when you consider the impending physician access crisis. The U.S. is already short 50,000 physicians, and the American Association of Medical Colleges estimates this shortage will grow to 150,000 by 2020.

The shortage could not come at a worse time. The shortage is growing just when demand for physicians’ service is peaking, as 78 million baby boomers started entering Medicare in 2011, and the health reform law starts covering at least 32 million more Medicaid recipients in 2014.

What are the states and government to do about this inevitable access crisis? The answers are multiple and legendary – more community health clinics, more nurse practitioners and physician assistants, more making caring for Medicare and Medicaid patients a condition for medical licensure, more easing up on the entry of foreign trained physicians, more creating more medical schools emphasizing primary care, more offering debt-free medical educations to students willing to serve in physician-short areas. These things take time, and so far, more has been less.

One thing seldom mentioned for attracting more doctors is national and state tort reform putting caps on malpractice rewards. This will probably not happen nationally because of the lobbying clout of the National Trial Lawyers Association, but has already occurred in Texas, and just recently in North Carolina.

Texas tort reforms have drawn 26,000 physicians to Texas, many of whom are now practicing in rural Texas, since 2004.

Why are physicians from elsewhere flocking to Texas? For the simple reason that doctors, particularly in high-risk specialists dread malpractice suits and higher malpractice premiums, even if plaintiffs lose in court. As an article in the August 18 New England Journal of Medicine, “Malpractice Risk According to Physician Specialty,”puts it, “Although annual rates of paid claims are low, the annual and career risk of any malpractice claims is high, suggesting that the risk of being sued alone can create a tangible fear among physicians.”

The article, based on a national study of 40,916 phy7sicians and 233,738 physician-years in 25 specialties, says most physicians will be sued at least once in their lifetimes, and in high risk specialties –neurosurgery, thoracic-heart risk surgery, general surgery, and ob-gyn – most specialists will be sued more than once, with the likelihood their malpractice premiums will escalate after each suit.

Small wonder, then, that Texas tort reform with caps and lower malpractice premiums, attracts doctors to the Lone Star state. Let us see if the same phenomonon takes place in North Carolina.


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