Doctors forced to limit or deny patient care

Health care lawsuit abuse is steadily eroding the quality and quantity of medical care available to Texans - especially those who need it the most, according to a weekend online poll of Texas Medical Association members.

Nearly two-thirds of the 1,027 physicians responding to the statewide survey say the climate in which they practice medicine has forced them to deny or refer high-risk cases in the past two years. More than half say they have stopped providing certain services to their patients. Nearly all said professional liability pressures were "very important" or "somewhat important" in their decision, as they are reducing services either to avoid higher liability insurance premiums or because of fear of lawsuits.

"The lawsuit abuse crisis is a cancer that is affecting our entire medical community and eating away at the quality of health care we're able to provide the people of Texas," said TMA President Charles W. Bailey, Jr., MD. "Accident victims, expectant mothers, and the very sickest patients, the ones who most need the brilliant minds and caring hands of the very best physicians in the state of Texas, are suffering the most."

To halt this crisis, TMA supports a four-point reform platform based on California's highly successful 1975 laws:

  • A $250,000 cap on noneconomic damages juries may award in health care liability cases;
  • Limitations on plaintiffs attorneys' contingency fees;
  • Periodic payments of future damages; and
  • Allowing juries to be told about other benefits available to the injured patient (such as personal health insurance or workers' compensation benefits).

The online survey of TMA member physicians documents that the crisis extends to all corners of the state and - directly or indirectly - to all specialties.

"This is not as big and obvious as the possible closing of one of the major emergency rooms in Dallas or Wadley Regional Medical Center losing its designation as a Level II Trauma Center," said Dr. Bailey. "But it's just as frightening."

For example, the survey found an obstetrician in Waxahachie who won't see any pregnant women with previous Cesarean sections or with a history of high blood pressure. Those women now have to drive 45 miles to Dallas to find a physician who will treat them. That may not be so easy either. One Dallas obstetrician, trained specifically to handle the most complex obstetrical cases, reported he has stopped delivering all babies.

Of those who responded to the survey, 62.1 percent have begun denying or referring high-risk cases in the past two years; 98 percent of them said professional liability pressures were "very important" or "somewhat important" in their decision. In addition, 51.6 percent have stopped providing certain services to their patients in the past two years; 96.9 percent of them cited professional liability pressures as "very important" or "somewhat important."

The survey also found:

  • A Houston orthopedic surgeon who no longer takes patients with neck or back problems;
  • A College Station anesthesiologist who now won't provide epidurals or other anesthesia to women in labor;
  • An Austin geriatrician who delays sending patients with complex problems to nursing homes and keeps them in hospitals longer than otherwise necessary;
  • An internist in Houston who has stopped screening his patients for colon cancer with a sigmoidoscope;
  • A Houston plastic surgeon who no longer covers the emergency room and won't accept referrals to repair complex hand and facial injuries;
  • An orthopedic surgeon in Austin who stopped doing hip and knee replacements for patients with arthritis;
  • A 46-year-old Fort Worth family practitioner who closed his practice altogether to go into the business world;
  • An anesthesiologist in El Paso who won't treat children any more. This means some children have to be sent to Lubbock for surgery;
  • A Houston internist who won't accept patients with chronic pain;
  • An emergency medicine specialist from Corpus Christi who won't respond to heart attack calls on the floors of the hospital right above his emergency room;
  • A Dallas internist who asks other doctors to see patients with chest pain or with complications of diabetes.

All actively practicing TMA physician members with e-mail addresses on file (a total of 12,058) were invited to participate in the online survey on April 10. Results were collected through 5 p.m. April 15. Responses were received from 1,027 physicians for a response rate of 8.5 percent.

Citizens Against Lawsuit Abuse

2500 City West Boulevard, Suite 300 • Houston, Texas 77042
E-mail: sosueme@ • Administrative: (713) 267-2302 • Fax: (713) 267-2267