Tort reform gives Texas doctors some relief

Texas is experiencing a small turnaround in its medical liability insurance climate eight months after Texas voters adopted a constitutional amendment that caps noneconomic-damage awards at $250,000.

Practices are reporting that it's easier to bring new physicians into the state, according to the Texas Medical Assn.

Some ob-gyns who gave up obstetrics because they couldn't afford the insurance are delivering babies again. And Texas physicians in training also increasingly report that they plan to stay in the state.

But doctors and some lawmakers say the picture isn't entirely rosy. They say there's still a way to go before recovery from the medical liability crisis is complete. Texas is one of 19 states that the American Medical Association calls a crisis state, in which physicians are leaving, curtailing high-risk procedures and retiring early because they can't afford or find insurance.

"We've stopped the hemorrhaging, but the patient is not well yet," TMA President Charles W. Bailey Jr., MD, said. "We are disappointed we haven't seen more rate reductions."

Texas Medical Liability Trust, which insures more than one-third of Texas physicians, dropped its rates by 12% Jan. 1. Other companies have not followed that example. But at least one company that was planning to file a rate increase opted not to increase rates, and other companies filed lower rate increases than originally expected, said Texas Dept. of Insurance spokesman Jim Hurley.

And the TMA and TDI have high hopes for the future based on the number of companies that want to write policies for Texas doctors. Ten carriers are taking steps to enter the state, Hurley said.

"Even though we are early on in the process, we are seeing a number of positive signs," he said.

"Competition is good," Dr. Bailey added.

Ohio insurers are encouraged as well.

Executives from the state's five largest medical liability insurers in April told legislators and the state-created Ohio Medical Malpractice Commission that tort reform, which includes a $350,000 cap on noneconomic damages, has created a more stable legal environment. But insurance executives said it will be key that the court uphold the cap.

"We believe the Ohio litigation and insurance environment is moving in the right direction," Paul Brutus, vice chair of Medical Assurance testified. "But it will take time."