Texas Alliance for Patient Access is a statewide coalition of doctors, hospitals, clinics, nursing homes and physician liability insurers.

6514 McNeil Drive, Suite 2-200

Austin, Texas 78729

(512) 703-2156

Legislative Victory

TAPA successfully lobbied for the passage of comprehensive medical lawsuit reforms.

Have Kept Texas’ Medical Liability Reforms

Intact thru 10 Legislative Sessions

Fended off attacks in the courts.

  • Filed 51 friend of the court briefs in an attempt to preserve legislative intent.
  • Set three years in court and $1.1 million in legal fees in successfully repelling a cap challenge in federal court.

Reforms are a key component in stopping the exodus of doctors - especially from our emergency departments - and attracting a record number of doctors to our state.

Today, Texas has more patient care physicians per capita than ever.

No matter how you measure it, Texas stacks up in attracting patient care physicians. 

  • 2nd in Raw Physician Growth
  • 5th in Percentage Physician Growth
  • 20th in Per Capita Physician Growth

Source: Association of American Medical Colleges 2008-2014, Active Patient Car Physicians (1). This is the only time frame for which comparative data is available on active patient care physicians.

Law Review cited in 26 Supreme Court and appellate opinions.

  • The scholarly article is widely regarded as a legislative intent road-map.
  • The Law Review has been cited in a combined 179 Supreme Court and appellate briefs.

Reducing the licensing logjam.

In 2007 TAPA successfully lobbied for an emergency appropriation and an increased biennial appropriation for the Texas Medical Board to hire licensing personnel.

Voters approve a constitutional amendment.

The TAPA membership contributed mightily and worked tirelessly in helping to pass Proposition 12, a constitutional amendment affirming Texas’ non-economic damage cap.

Effective reforms halt crisis.

  • In 2005, Texas became the first state to be removed by the American Medical Association’s list of states in medical liability crisis.
  • Subsequently, doctors returned to the ER and came to Texas in record numbers.

Real Reform: The Right Prescription for Health Care.

“The Texas Alliance for Patient Access was a galvanizing force behind the passage of Texas’ much-needed medical liability reforms.”

Rick Perry, former Governor of Texas

Texas Medicine August'September 2023 article by Sean Price

TMA Moment in Time: Medical Liability Reform on this 20th anniversary of tort reform, Texas physicians look back on the coalition that ended our-of-control lawsuits

By Sean Price

Texas Medicine August/September 2023

In 2002, David Cantu, MD, was the only Spanish-speaking physician in the Fredericksburg area delivering babies.  But like many Texas physicians at that time, the family physician’s medical liability insurance premiums soared so high that he had to stop all obstetric services.

“Even though I was doing five or six deliveries per week, it was just barely making the overhead for the insurance - or less,” he said.

Some of Dr. Cantu’s patients could turn elsewhere.  But many couldn’t because of the language barrier or because they had Medicaid coverage, and no other local physician could afford to take them.


Southeast Texas Record February 21, 2023
Southeast Texas Record March 2, 2022

Texas Supreme Court Rules in Favor of Emergency Room Doctor

The Texas Supreme Court ruled in favor of emergency room physician Dr. Kristy Marsillo on January 11, concluding the plaintiff produced no evidence that her treatment of a snakebite was willfully and wantonly negligent, the required standard of proof in an emergency care case.

Thirteen-year-old Raynee Dunnick presented to Seton Medical Center Hays in Kyle with a rattlesnake bite on her left foot. Dr. Marsillo immediately implemented the hospital’s snakebite treatment plan, monitored the patient’s vital signs, repeatedly ordered blood work, and re-examined the severity of the injury to determine whether and when to administer antivenom. 

TAPA files brief contending conclusory and unexplained statements are not evidence of a material fact

On December 22, 2022, TAPA filed an amicus brief in the Texas Supreme Court in a case regarding treating a snake bite in a hospital emergency department.

Particularly troublesome was the Third Court of Appeals’ holding that reversal of the trial court’s summary judgment ruling was warranted because “a possibility” existed that the physician was guilty of consciously putting her patient at extreme risk of harm. 

Possibilities are not evidence, and allowing this reversal to stand has worrisome implications, including a watering down of the evidence required for a plaintiff to sue in an emergency department case.


Austin, TX-- Austin attorney Brian Jackson has been named the new executive director of Texas Alliance for Patient Access. Jackson replaces the retiring Jon Opelt, who led the organization for 19 years.
Texas Civil Justice League April 27, 2023 AUSTIN - On Friday, the Texas Supreme Court found that a trial court improperly denied defendant health care providers an offsetting settlement credit in a medical malpractice suit that resulted in a $14 million judgment.
Texas Supreme Court issued an opinion providing guidance on how courts should apply the periodic payments provision

Austin Attorney Chosen as New TAPA Leader. Jackson will protect Texas’ Historic Medical Liability Reforms

Austin, TX-- Austin attorney Brian Jackson has been named the new executive director of Texas Alliance for Patient Access. Jackson replaces the retiring Jon Opelt, who led the organization for 19 years.

Jackson has defended physicians, hospitals, and nurses in medical liability cases for 33 years. He has served as TAPA’s General Counsel since 2016 and will now become TAPA’s full-time executive director while still maintaining a part-time law practice.

TAPA is the unified voice of Texas healthcare on medical liability matters. Its members include the Texas Medical Association, Texas Hospital Association, medical clinics, hospitals, nursing homes, charity clinics, and other healthcare organizations.

Federal Judge Dismisses Challenge to Caps on Non-economic Damages

Texas Civil Justice League

April 27, 2023

Austin Federal District Judge Lee Yeakel has dismissed a challenge to Texas’ cap on noneconomic damages in medical liability cases. Plaintiffs in Winnett, et al. v. Frank, et al. (No. 1:20-cv-01155-LY) contended that: (1) the Seventh Amendment of the U.S. Constitution should be incorporated through the Fourteenth Amendment and made applicable to the states; and (2) Texas’ cap on noneconomic damages in health care liability claims violates the Seventh Amendment’s guarantee that the right to a jury trial shall be “preserved.”  There has been a long-held view, supported by U.S. Supreme Court precedent, that the Seventh Amendment’s right to a jury trial does not apply to the states. 

Texas Supreme Court clarifies future periodic payment provision element of 2003 liability reforms on rehearing

On April 22, the Texas Supreme Court issued an opinion providing guidance on how courts should apply the periodic payments provision, a key element of the state’s 2003 landmark medical liability reforms, holding that the structure must in some way conform to the evidence presented to the jury at trial.

Brent Cooper, an attorney for Texas Alliance Patient Access, says the high court’s decision will be useful for healthcare defendants going forward.

“It puts parameters around the trial court’s decision and makes that decision reviewable by a higher court should the trial court fail to follow the statute,” Cooper said.

Despite claims by the trial lawyers, the threat of a lawsuit or a higher damage award has little to no association with improved healthcare quality and patient safety.
The ratio of patient-care physician's to Texas' overall population hit an all-time high in 2019.
CNN News Video

Study finds no correlation between harsher medical liability laws and improved patient care

Despite claims by the trial lawyers, the threat of a lawsuit or a higher damage award has little to no association with improved healthcare quality and patient safety. The absence of a correlation was the key finding in a recently published study in the Journal of the American Medical Association entitled “Malpractice Liability and Health Care Quality.” The authors found no consistent relationship with patient outcomes in states with harsher tort laws.

Record Number of Doctors Arriving to Care for Texas Patients

Yes, we need more doctors, but our physician growth rate is actually quite impressive. The ratio of patient-care physicians to Texas' overall population hit an all-time high in 2019, according to data released by the Texas Department of State Health Services. But that's not really the good news. The best news is that the ratio has grown without interruption in each year of the past decade.

Texas is adding new physicians faster than the population.

Former TAPA Executive Director Jon Opelt discusses the importance of protecting Texas’ 2003 landmark medical liability reforms. He notes that many of Texas’s newly minted doctors have cited the state’s more hospitable legal climate as a significant factor in their choosing to practice here. Passage of these reforms has substantially reduced lawsuits and liability costs and have increased the number of doctors practicing in the state; especially pediatric, geriatric, and high-risk specialists.


Howard Marcus awarded plaque for twenty years of service and success.

Former Chair Lauded for Twenty Years of Service and Success

Twenty Years of Success. At the November 19 annual membership meeting, newly elected TAPA Chair Dr. Robert Hancock and outgoing Vice-Chair Vicky Gould presented Dr. Howard Marcus with a plaque commending his twenty years of commitment to bettering Texas’ medical liability climate and improving access to care. The importance of Dr. Marcus’ contribution can be sized up in a letter from former Texas Governor Rick Perry.

Tim Seay, president of Greater Houston Emergency Room
By Ted Shaw The Texas Tribune (Online) April 20, 2015
The Washington Post November 4, 2015

More high-risk doctors are flocking to Texas

Tim Seay, president of Greater Houston Emergency Room

Physicians had grown accustomed to unsuccessfully begging physicians to come to the Houston area. That was before Texas passed health.

Texas knows how to solve health care problems

By Ted Shaw

The Texas Tribune (Online)

April 20, 2015

In 2003, Texas health care was in full-blown crisis. There were not enough physicians, particularly in high risk, hospital-based specialties, such as obstetrics, neurosurgery and trauma.

Why health reform might increase malpractice lawsuits

The Washington Post

November 4, 2015

A possible unintended consequence of one of health reform's biggest goals — curbing excess health care spending — could be a surge in malpractice lawsuits.

The following is a discussion of the Ross decision with Texas Supreme Court Justice Phil Johnson.
A letter to the editor in the August 22 edition of Syracuse.com notes that more than half of newly trained doctors are fleeing the State of New York.
Twelve years after its passage most elements of Texas' landmark medical lawsuit reforms have been upheld.

What is a health care liability claim in Texas?

Language in the 2003 reforms created a conundrum for lawyers, judges and health care providers when violations of safety standards were alleged. The Texas Supreme Court largely erased that confusion when it handed down the Ross v. St. Luke’s Episcopal Hospital decision May 1, 2015. The following is a discussion of the Ross decision with Texas Supreme Court Justice Phil Johnson.

Texas ranks second nationally in retention of in-state trained physicians

A letter to the editor in the August 22 edition of Syracuse.com notes that more than half of newly trained doctors are fleeing the State of New York.

The opinion piece reports that New York trains approximately 16,000 medical students each year. Only 45 percent of those newly-trained physicians choose to stay in-state to work.

Key Court Decisions since the Passage of Reforms

The law is what the courts say it is. Twelve years after its passage most elements of Texas' landmark medical lawsuit reforms have been upheld. Some of the medical liability provisions have been adjudicated at an intermediate court only. Click here for a chronology of the more significant decisions rendered by the courts.

122 Texas Counties See Gains in ER Docs
Change in Percentage of High Risk Specialists

TEXAS ALLIANCE FOR PATIENT ACCESS

6514 McNeil Drive, 2-200

Austin, Texas 78729

512.703.2156

CONTACT BRIAN G. JACKSON

Copyright 2021 TAPA         All Rights Reserved. 

Privacy Policy

TEXAS ALLIANCE FOR PATIENT ACCESS

6514 McNeil Drive, Suite 2-200

Austin, Texas 78729

512.703.2156

CONTACT BRIAN JACKSON

Copyright 2021 TAPA         All Rights Reserved. 

Privacy Policy