Lawsuits dashing doctors’ dreams
and patients’ access to healthcare

By Jon Opelt
Carlos Cardenas was born, reared and is now in his 12th year of private practice—as a gastroenterologist—in McAllen. Cardenas is living his dream, even rising to the ranks of president of the local medical society.

Holding on to that dream is becoming harder. Skyrocketing insurance costs, fueled by rising numbers of malpractice claims and lawsuits, are pushing Cardenas and many physicians to consider leaving the state or medicine altogether.

“I would have never thought that practicing good medicine could get you in trouble,” Cardenas told me. “But many good doctors are now afraid of performing high-risk or life-saving procedures.”

Even Leo Boyle, the president of the American Trial Lawyers Association (“Insurers, heal latest malpractice ‘crisis’ thyselves”, Houston Chronicle, May 14) would agree with Dr. Cardenas that a few “bad” doctors are causing most of the medical malpractice. However, as quick as Mr. Boyle is to blame a few bad doctors, and chastise doctors’ associations for failing to police their own, Mr. Boyle makes no mention of cleaning his own house.

Six out of every seven medical malpractice claims in Texas are closed with no fault found on the part of the doctor, meaning many had no merit in the first place. Nonetheless, tens of millions of dollars are being spent fighting these cases. And some folks wonder why healthcare costs are high.

So who is punishing lawyers who bring baseless medical malpractice claims? Who is punishing judges who fail to enforce the law requiring lawyers to post a bond for costs or have a credible expert witness report before allowing a medical case to go forward?

Not Mr. Boyle, whose members are the only ones who benefit from the present system.

It’s not just the “bad-apple” doctors that are being sued. Family physician Marissa Iniga has been sued 12 times in the past 13 years. All of the lawsuits were dropped but her insurance premiums still went up 200 percent. And when defending herself is taking most of her waking hours, she can’t see patients.

Unbridled lawsuits have turned entire regions of the state into high-risk areas to practice medicine. From the Gulf Coast to the border to North Texas, communities are having trouble attracting and retaining medical specialists. Patients are losing access to their physicians.

Eight insurance companies are either not renewing medical liability policies or have announced their withdrawal from Texas by the middle of next year. That leaves more than 6,100 physicians scrambling to find liability insurance.

Texas used to have 17 medical liability insurers; now it has four. The remaining four insurers don’t have the capacity to absorb 6,100 new policies. Many doctors will be turned away. Medically underserved areas like Corpus Christi and the Rio Grande Valley have lost specialists in neurology, pediatric surgery, orthopedics and obstetrics.

It seems that the McAllen area’s only neurosurgeon is either in the operating room or in the courtroom. When he is unavailable, those suffering from severe head injuries must be stabilized and sent via Life Flight to a distant hospital where they can get the specialized care they critically need. Statewide, several head injury patients died in the past year before they could be successfully transported to a receiving hospital.

Texas doctors are looking to California for proven lawsuit abuse reforms. California’s Medical Liability Compensation Reform Act is often hailed as the “gold standard” for protecting both physicians and patients. Passed in 1975, it caps pain and suffering awards at $250,000 per defendant and sets legal fees. According to The Wall Street Journal, the reform has held down liability costs for doctors and hospitals while speeding settlements and fairly compensating patients who have been harmed.

Medical liability rates in California are lower than most every state and have remained remarkably stable for the past 25 years. An internist in Harris County pays medical liability rates double that of his California counterpart. The disparity is almost as great for general surgeons. As Dr. Richard Corlin, president of the American Medical Association noted, “Obstetricians in Las Vegas know that simply by moving across the border into California, their liability premiums will drop more than $100,000. Same physician, same skills, different legal climate.”

The medical crisis will soon become a catastrophe for each and every Texan. If you are expecting personal injury lawyers to begin policing their own, I hope you're not holding your breath, because there may not be a doctor available when you pass out.

Opelt is the Houston director of Citizens Against Lawsuit Abuse, a legal watchdog group. Readers can e-mail him at sosueme@

Citizens Against Lawsuit Abuse

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