Thanks to new legal protections, doctor applications in Texas are spiking

March 21, 2007

San Antonio Express-News

Physicians are flocking to Texas , thanks to limits on malpractice lawsuit awards.

In fact, so many doctors are applying for Texas licenses that a logjam has formed, and hospitals and clinics are worried that some applicants will go to other states rather than wait three to six months for a Texas license.

Statewide approval of Proposition 12 in 2003 triggered the rush for applications. Before Proposition 12, the state did not impose a cap on the amount of noneconomic damages in a malpractice lawsuit against doctors. Proposition 12 established a cap of $250,000.

The result of the legal protection is a landslide of doctors wanting to move to Texas.

In 2001, the Texas Medical Board processed 2,446 licenses for doctors, including those who had just received Texas medical school degrees. In fiscal 2005, the number rose to 2,992. But in fiscal 2006, ended Aug. 31, the number jumped to 4,026.

"Poof. It exploded," board spokeswoman Jill Wiggins said.

Halfway through fiscal 2007, or through the end of February, the number of pending licenses stood at 2,063, which puts the board on track for 4,100 for the fiscal year.

But instead of 8,000 new doctors opening practices in Texas in a two-year period, Dr. Donald Patrick, Texas Medical Board executive director, fears that only 6,000 to 7,000 will end up in Texas because of the backlog.

Before the crush, the board could license a clean application from a doctor just out of medical school in 18 days. But the wait has grown to 84 days for easy applications — those from doctors right out of medical school — but more than six months for physicians with work histories, he said.

"It's like Interstate 35 at 5 p.m. It isn't moving. There's too many cars," Patrick said. Because applications are delayed, doctors call the office to inquire, causing further delay.

Former state Rep. Joe Nixon of Houston , who sponsored Proposition 12, said $400,000 would be needed in an emergency appropriation to eliminate the logjam. That much money would add six license application positions and a new computer system.

Members of the Legislature are trying to push the emergency legislation through so the board can start processing applications immediately. Otherwise, the board must wait until September before any new money arrives, Nixon said.

"We're praying it happens," Patrick said of the emergency funding request.

The board has eliminated other possible explanations for the flood of applications. Only 4.5 percent of the total come from the hurricane-damaged gulf region, so that is not a large factor. New York , California and Florida are the top three states for applicants other than Texas.

Patrick and Nixon said the bigger supply of doctors would improve patient care in Texas . "They can't all go to the medical centers," Patrick said. Instead, many new doctors are likely to start practices in underserved rural and inner-city areas.

"We have understaffed clinics, hospitals and emergency rooms," Nixon added. "If we could get these doctors licensed immediately, this would be nothing short of wonderful."

Each doctor is like a small business, needing staff, suppliers and professional services, and Texas wouldn't stand for such delays getting any other small businesses started.

The state ought to pay the small sum of $400,000 to capitalize on the number of doctors who want to practice in Texas .