In his 18 years of practice McAllen heart surgeon Norman Hetzler had never been sued. That changed a few years ago when he was hit with eight malpractice suits in rapid succession.
Seven of the eight patients who sued Dr. Hetzler did well after surgery, and all cases were either dropped or dismissed, which was hardly a consolation.
With his reputation in taters and his malpractice premiums skyrocketing, Dr. Hetzler decided it was time to leave the Rio Grande Valley. He closed his practice and moved to Pennsylvania to open a cardiac care center.
DOCTORS' PRACTICES IN PERIL
His dilemma, though more pronounced than most, was hardly unique. With malpractice lawsuits and awards on the rise statewide, many doctors suddenly found their practice in peril.
A 2001 study by the Texas Medical Association revealed that six out of every seven medical malpractice claims in Texas were being closed with no fault found on the part of the doctor, meaning many lacked merit. Nonetheless, tens of millions of dollars were being spent fighting these cases.
The burgeoning malpractice crisis coupled with slow pay by health insurers and reduced pay by Medicare and Medicaid put doctors through the financial wringer. Reportedly, more than two-thirds of Texas physicians dipped into their retirement funds, got a bank loan or took a cut in salary to keep their practice afloat.
Unbridled lawsuits turned entire regions of the state into high-risk areas to practice medicine. From the Gulf Coast to the border to North Texas, communities were having trouble attracting and retaining medical specialists. Patients were losing access to their doctor.
Data from the state medical board revealed that over two-thirds of the counties in Texas didn't have a licensed obstetrician, more than half of the counties had no pediatrician, and almost one-third of the counties had no family physicians
CATASTROPHE IN THE MAKING
The Texas medical liability system was a catastrophe in the making.
"Physicians are dramatically changing the way they practice medicine in the State of Texas and it’s affecting patient care,
said Dr. Craig Bonnen, a Houston neurosurgeon, speaking before a Texas Senate panel. “Most of the physicians where I practice medicine in Greenville are not doing nursing home work anymore. This is happening all over the state," he said
"Physicians are getting out of hospital work. This is happening all over the state. You're losing continuity of care from the office to a hospital. Physicians are less likely to take what are considered risky cases," said Dr. Bonnen. "They're referring out more, which increases the cost of medicine. Most physicians can’t afford to even buy two hundred and fifty thousand dollars worth of malpractice now."
"Many physicians are retiring early or they’re not in a position to provide charity care,” he said. Critical shortages of both doctors and nurses were being reported across the state. The state board of medical examiners found that Texas ranked well below the national average of physicians per capital. No only were doctors leaving the practice of medicine, many were opting out of certain high-risk specialties.
EMERGENCY DECLARATION
Within days of the protest marches, both the Governor and his challenger announced, if voted into office, they would make medical liability reform an emergency issue thus giving it fast-track priority status in the Legislature.
Weeks of testimony in both the Texas House and Senate led to the passage of a comprehensive medical liability reform bill in 2003. Key elements of that legislation can be found on this web site under the heading Recently Passed Med Mal Reforms. Texas lawmakers made great strides in quelling the crisis by passing:
- A non-economic damage cap
- Protections for emergency care
- Allowing periodic payments for future damages, and
- Implementing sweeping expert witness reforms that will presumably reduce lawsuit costs
and the number of frivolous filings.
Yet, more still needs to be done to repair the state's medical liability system. Click on Legislative Solution for a discussion of essential reforms that remain unaddressed.
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