Malpractice, tort reform - Texas Medical Association and Power of State Medical Assocations to Make a Difference

Other state medical associations must envy the Texas Medical Association (TMA). For good reason. In Lou Goodman, its EVP/CEO, it has had a strong leader for 20 years, and it has more members, 43,000, than any other state society, even more than California, which has 90,000 physicians but fewer members in the California Medical Association. I expect the reason for this difference is managed care dominance in California.

Lou also now serves as president of the Foundation for Health System Excellence, which represents national state medical societies. TMA has solid reserves, and its members accompany many national leadership positions. The power of state medical societies resides in the fact that state medical societies are closer to their physician constituencies that national organizations, like the AMA or national specialty societies. Another factor may be that America is a bottom-up society that understands local and regional cultures.

The TMA is perhaps proudest of pushing through a constitutional amendment in 2003 which limited non-economic damages in medial liability cases to $250,000. Texas voters backed the amendment.

The result of this amendment has been an influx of much needed specialists to Texas. The cap on damages makes a difference. High malpractice premiums are a hot bottom issue among physicians, and lower premiums such as those indicated below are a real drawing care.

Rate Changes since 9/23

Texas Medical Liability Trust -31.3%

Medical Protective -19.7%

American Physicians Insurance Co. -17.4%

Advocate, MD Ins. Of the Southwest -29.5%

All Reporting Members -25.1%

With these premiums has come an immigration of badly needed specialists who are tired of paying exorbitant premiums in other states.

Number of Texas Neurosurgeons

2003 407 +12.4%
2008 456

Number of Texas Obstetricians and Gynecologists

2003 2830 +7.2%
2008 3035

Number of Texas Orthopedic Surgeons

2003 1790 +9.1%
2008 1953

But Texas doctors aren’t out of the malpractice woods yet. Opponents have taken the cap to federal court saying it is unconstitutional and violates patient rights to a jury trial and due process rights. Perhaps now we shall see who counts most – doctors providing the care or lawyers limiting the care.