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Tort Reform Does Not Affect Physician Supply

Beyond money, another common claim propagated by those pushing for tort reform laws is that these special immunities for medical professionals are needed to increase doctor supply. Claims are commonly made about a woeful lack of access to health care. This lack of access is not connected to financial constraints or insurance problems but, claim certain groups, caused by doctors moving away from certain areas.

Is this true? Hardly. The Center for Justice & Democracy Briefing Book lays out the reality.

The Texas Example
Perhaps the clearest example of the myth of tort reform and physician supply comes from Texas. The state passed particularly tight medical malpractice cap rules in 2003. In fact, the limitation on patient rights was enshrined in the state’s constitution. Voters were willing to give up their legal rights under the assumption that there were be alternative public goods coming from eliminating accountability for medical errors. One of those supposed benefits was an increase in physician supply.

Expectedly, close analysis of the state shows clearly that the benefit did not actually arise. A lauded comprehensive investigation into this issue was conducted this very year, including by legal professionals from Chicago and the University of Illinois. The investigation is by far the most thorough controlled examination of physician supply in Texas before and after the tort reform laws passed.

What did they find? The claims about an “amazing turnout” in physician supply following the law is pure fantasy. This was for two reasons: (1) The claims about a “mass exodus” of doctors before the law was not true; and (2) There was not a mass increase following the law.

First, evidence clearly shows that the number of “direct care physicians” (DCPs) increased steadily in the decade before the law passed (from 1993 – 2003). This was the case even while insurance rates increased in the state. In other words, it was still possible to be profitable and practice medicine in the state before the tort reform law.

Second, after the law, there is no sharp rise (or any rise at all) as a result of the law. The rate of growth from DPCs was roughly the same before and after tort reform legislation–if anything, growth slowed slightly after the 2003 law.

The case doesn’t get any better when looking away from DCPs and toward specialists. More specialities than not (i.e. ob-gyn and orthopedic surgery) grew faster before the law than after. The authors of the latest study concluded; “claims of dramatic post-reform inflows of ob-gyns, orthopedic surgeons, or neurosurgeons are unfounded.”

In addition, there is not even any evidence that the law influenced where those physicians practiced. Some argued that the constitutional amendment was necessary to get doctors to move to less-serviced rural areas of the state. But that did not happen after the law.

The bottom line is that, the “physician supply” argument–which was likely the single most important factor in pushing the Texas law–did not bear fruit. Community members gave up basic legal rights in exchange for claimed benefits that never actually materialized.

See Our Related Blog Post:

CJ&D Briefing Book: Who Commits the Malpractice?

CJ&D Briefing Book: The Truth About Medical Malpractice Lawsuits