Tort Reform Is Associated with Significant Increases in Texas Physicians Relative to the Texas Population
Texas implemented comprehensive tort reform in 2003. We hypothesized that tort reform was followed by a significant increase of physicians practicing in Texas.
To test this hypothesis, we compared the rate of physician growth prior to and following tort reform, and the number of licensed physicians and physicians per 100,000.
Comparing before and after tort reform, the rate of increase in Texas physicians per 100,000 population increased significantly (p < 0.01). From 2002 to 2012, the Texas population increased 21 %. The number of actively practicing Texas physicians increased by 15,611 a 44 % increase (46 % metro areas vs. 9 % non-metro areas), an increase of 30 physicians per 100,000 population (p < 0.01). Non-metropolitan Texas had a net increase of 215 physicians; however, there was no change in the number of physicians per 100,000. Examining the data by trauma service areas (TSAs), 20 of 22 TSAs had an increase in both number of physicians and physicians per capita, five greater than 50 %.
The post-tort reform period in Texas was associated with a significantly increased growth rate of physicians relative to the Texas population. Tort reform, as implemented in Texas, provides a needed framework for improving access to health care.
- Conde C, Fagan D. Prop 12 payoff. Tex Med. 2007 Sep;103(9):18–24.
- Hutchison KB. Texas liability reform an example for the nation. Tex Med. 2006 Jul;102(7):5–6.
- HB 4, Texas Legislature (2003).
- Texas Constitution, Article 3, Section 66.
- Journal WS (ed) (2008) Doctors flock to Texas after tort reform. WSJ Health Blog: Wall Street Journal.
- Ellington CR, Dodoo M, Phillips R, Szabat R, Green L, Bullock K. State tort reforms and hospital malpractice costs. Journal of Law, Medicine and Ethics. 2010 2010;38(1):6.
- Stewart RM, Geoghegan K, Myers JG, Sirinek KR, Corneille MG, Mueller D, et al. Malpractice risk and cost are significantly reduced after tort reform. J Am Coll Surg. 2011 Apr;212(4):463–7, 7 e1–42; discussion 7–9.
- Marcus H. Guest column: better care, thanks to tort reform. Texas Tribune. 2011 October 24, 2011.
- Silver CM. Guest column: no better care, thanks to tort reform. Texas Tribune. 2011 October 24, 2011.
- Texas Medical Board. Texas Medical Board Physician Demographic Information. Austin, Texas: Texas Medical Board; 2012 [updated January 12, 2012; cited 2012 May 12, 2012]; Available from: http://www.tmb.state.tx.us/agency/statistics/demo/docs/docdemo.php.
- Commission TSLaA (2011) United States and Texas Populations 1850–2010. Available from: https://www.tsl.state.tx.us/ref/abouttx/census.html.
- Texas Department of State Health Services. Population Data for Texas. Austin, Texas: Texas Department of State Health Services; 2012 [cited 2012 May 12, 2012].
- SB 104, Texas Legislature, 78(R) Sess. (2003).
- Tort reform in Texas: one year later. J Okla State Med Assoc. 2006;99(1).
- Nixon J. Why doctors are heading for Texas. Wall Street Journal. 2008 May 17, 2008.
- Albert T. Rhode Island slides into liability crisis; Texas escapes. American Medical News. 2005 June 6, 2005.
- Texas Civil Justice League. Liability Caps Special Report. Austin, Texas 2010.
- Gallegos A (2011) Texas tort reform advocates dispute critical report. American Medical Association, Chicago, IL. [cited 2012 May 12, 2012] Available from: http://www.ama-assn.org/amednews/2011/10/31/prsc1031.htm
- Lincoln T. A failed experiment: health care in Texas has worsened in key respects since state instituted liability caps in 2003. Austin, Texas, 2011 October 2011.
- Hyman DA, Silver CM, Black BS. Does tort reform affect physician supply? Evidence from Texas. SSRN eLibrary. 2012.
- Frankel G. Malpractice risk and cost. J Am Coll Surg. [Comment Letter]. 2011 Sep;213(3):454; author reply 5.
- Hsieh MH, Tan AG, Meng MV. Medical malpractice in American urology: 22-year national review of the impact of caps and implications for contemporary practice. J Urol. 2008 May;179(5):1944–9; discussion 9. CrossRef
- Studdert DM, Mello MM, Gawande AA, Gandhi TK, Kachalia A, Yoon C, et al. Claims, errors, and compensation payments in medical malpractice litigation. N Engl J Med 2006 May 11;354(19):2024–33. CrossRef
- Tort Reform Is Associated with Significant Increases in Texas Physicians Relative to the Texas Population
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of Gastrointestinal Surgery
Volume 17, Issue 1 , pp 168-178
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Licensure, medical
- Liability, legal
- Health care reform
- Tort reform
- Insurance, liability
- Health policy
- Healthcare access
- Industry Sectors
- Author Affiliations
- 1. Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- 2. University Hospital, San Antonio, TX, USA
- 4. Jocelyn and Joe Straus Endowed Chair for Trauma Research, Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
- 3. Texas Hospital Association, Austin, TX, USA